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Depression Ruins Lives – What If My Child Has It?

Depression doesn’t just affect adults. Children and teenagers can get depressed too.

Some studies show that almost one in four young people will experience depression before they are 19 years old.

It’s important to get help early if you think your child may be depressed. The longer it goes on, the more likely it is to disrupt your child’s life and turn into a long-term problem.

Signs of depression in children

Symptoms of depression in children often include:

  • sadness, or a low mood that doesn’t go away
  • being irritable or grumpy all the time
  • not being interested in things they used to enjoy
  • feeling tired and exhausted a lot of the time

Your child may also:

  • have trouble sleeping or sleep more than usual
  • not be able to concentrate
  • interact less with friends and family
  • be indecisive
  • not have much confidence
  • eat less than usual or overeat
  • have big changes in weight
  • seem unable to relax or be more lethargic than usual
  • talk about feeling guilty or worthless
  • feel empty or unable to feel emotions (numb)
  • have thoughts about suicide or self-harming
  • actually self-harm, for example, cutting their skin or taking on overdose

Some children have problems with anxiety as well as depression. Some also have physical symptoms, such as headaches and stomach aches.

Problems at school can be a sign of depression in children and teenagers and so can problem behaviour, especially in boys.

Older children who are depressed may misuse drugs or alcohol.

Why is my child depressed?

Things that increase the risk of depression in children include:

  • family difficulties
  • bullying
  • physical, emotional or sexual abuse
  • a family history of depression or other mental health problems

Sometimes depression is triggered by one difficult event, such as parents separating, a bereavement or problems with school or other children.

Often it’s caused by a mixture of things. For example, your child may have inherited a tendency to depression and also have experienced some difficult life events.

If you think your child is depressed

If you think your child may be depressed, it’s important to talk to them. Try to find out what’s troubling them and how they are feeling.

See some tips on talking to younger children and talking to teenagers.

Whatever is causing the problem, take it seriously. It may not seem a big deal to you, but it could be a major problem for your child.

If your child doesn’t want to talk to you, let them know that you are concerned about them and that you’re there if they need you.

  • Encourage them to talk to someone else they trust, such as another family member, a friend or someone at school.
  • It may be helpful for you to talk to other people who know your child, including their other parent.
  • You could also contact their school to see if they have any concerns.

When to get medical help

If you think your child is depressed, make an appointment with them to see your GP (*doctor).

  • If necessary they can refer your child to their local child and adolescent mental health service (CAMHS) for specialist help (in the UK)**.
  • See more about CAMHS.
  • If you are worried about any aspect of your child’s mental health, you can call the charity YoungMinds’ free parents’ helpline (in the UK)** on 0808 802 5544 for advice.
  • The YoungMinds website also has mental health support and advice for your child.

Editor’s Note: *clarification provided for our US readers.

** Resources in the United States





A Pediatrician’s Unique Perspective on Dads and Babies

Most human Mom’s live with their babies developing in their uteri for about 9 months. During this time, they both experience the physiologic and personality changes associated with pregnancy. Dad too has been involved but in a much more subtle and marginal way.  He has seen the remarkable changes occurring in the mother of his child almost on a daily basis and has looked on in awe and wonderment at her growing belly and occasionally has been lucky enough to have been present when the movement of the fetus can be seen and felt through the mother’s abdominal wall.  If he was lucky enough to attend her prenatal visits he might even have caught a glimpse of the actual baby moving through the magic of sonography.

Some men, rarely, have expressed a feeling of disappointment at not having had the same experiences moms have.  Most Fathers, however, have experienced the same joy and elation at seeing their newborn baby for the first time as Moms.  There is that certain feeling of witnessing a miracle that doesn’t come along every day.  Just imagine that little perfect person with everything an adult has but just in miniature.  In fact, the production of a baby is, by all accounts, a miracle of such huge proportions that volumes of books and stories have been written and seen and read on this topic alone.

A father develops a special bond with his baby that can almost not be put into words. The presence of a father adds a certain amount of stability immediately to the family unit and, if Mom will allow the participation of the Father in an equal manner with her, then the family unit is strengthened even more- and the father feels less like an outsider and more like an active influence on the development of the baby.

In fact, fathers should be encouraged to take a very active role in the care of this infant right from birth.  A father taking his baby to the Doctor’s office for regular visits is becoming far more common now than it ever used to be.  I remember as a young intern and resident with a very busy day and night schedule I could not attend very many of my childrens’ doctor visits and could only listen in amazement at the reports my wife would give me in the evening when I finally got home.  To this day I feel cheated of some of the elation that came when our baby’s doctor could confirm that our care was certainly correct and of great benefit for our child.  After all, babies do not come with instructions or warranty manuals and it is important for parents to have their parenting skills recognized and confirmed by an objective third party. 

Erin Pougnet’s studies of fathers’ influence on children’s cognitive and behavioural functioning have shown greater achievable IQ levels in children with whom the father has paid a greater role during early infancy and childhood.  Fathers are known to contribute different ways of looking at non-verbal skills as they take part in the physical contact of their children (playing roughly) and offer another definition of reasoning. Recent evidence gathered from families in which the father is absent due to armed forces responsibilities show that there are more stresses, sadness, withdrawal and aggressive behavior when Dad is away for any significant time span. Families in older generations suffered from the father’s inability to express appropriate feeling toward his children; now it is felt that younger fathers have these skills.

A Father should never be a casual observer to the growth and development of his child but an active contributing member of the family unit.  Prenatal classes of a different kind than those for expectant mothers should be offered to the father- to- be as well, so that his role can be more clearly defined. As research has shown, dad’s increasing involvement is making a difference.

My Transgender Daughter, Nicki: A Story of Suffering and Survival

Sharon has a teenage daughter who is transgender. She describes how Nicki was born in a male body but felt from a very young age that she should have been a girl.

“When my child Nick was about two, I realised that he wasn’t playing with toys that I expected a boy to play with. He was interested in dolls and girly dressing-up clothes. At that age, it doesn’t really matter. You just think they’re trying lots of different things, so I never made a fuss about it.

My-transgender-daughter“But when he was four years old, Nick told me that God had made a mistake, and he should have been a girl.

“I asked my GP what I should do. He told me to wait and see, and that it might just be a phase and go away. But it didn’t. It got stronger.

“One day when Nick was six, we were in the car, and he asked me when he could have the operation to cut off his ‘willy’ and give him a ‘fanny’ (*vagina). His older cousin had told him about these things.

“I spoke to a friend who’s a psychiatrist. He said I should contact the Tavistock Clinic [now The Tavistock and Portman service for children and young people with gender identity issues].

“He also told me that the medical term is ‘gender dysphoria’. When I looked it up online, I found Mermaids, a charity that helps children with gender identity issues and their families.

“I also spoke to my GP again, who referred us to the local mental health unit. The person at the unit had worked at the Tavistock and knew about gender identity issues.

“He was brilliant. It was such a relief to talk to somebody who understood what was going on. I’d blamed myself, but he reassured me that it wasn’t my fault. We were then referred to the Tavistock Clinic.

“The team from the Tavistock came to Nick’s school and talked to the teachers. They helped the teachers to understand that Nick wasn’t being difficult, and that this may or may not be a phase. When a child is this young, you just don’t know.”

From Nick to Nicki

“Nicki desperately wanted to be female all the time. When she was 10, we feminised her name from Nick to Nicki at home. The following year, Nicki started secondary school as a girl.

“The school was very supportive, but because she moved up to secondary school with her peer group, everybody knew.

“In the first week, she was called a ‘tranny’ and a ‘man-beast’. She was spat on and attacked in the corridors. Within her first six months of being at that school, she took four overdoses.

“We then pulled her out of school, but after a few months she decided to go back.

“Each year, the bullying and isolation got worse, and Nicki started harming herself. At the beginning of year nine, I transferred her to another secondary school, but unfortunately the kids there found out.

“At that point, I withdrew her from school completely, and the education welfare office found her a place at a Specialist Inclusive Learning Centre, which is a unit for children who can’t cope with mainstream schooling for various health reasons.”

Going Through Puberty

“When Nicki started puberty, I wanted her to get the type of treatment that’s offered in the Netherlands, where puberty is blocked before major physical changes take place.

“I felt that if she was going to change her mind about being a girl, she would have done so by now.

“The Tavistock Clinic wouldn’t give her hormone blockers. [The Tavistock and Portman follows British guidelines, which at the time suggested not introducing hormone blockers until the latter stages of puberty. Since January 2011, the age at which hormonal treatment may be offered has been lowered from 16 to 12, under a research study that is being carried out by the Tavistock and Portman into the effects of hormone blockers earlier in puberty.]

“In the end, we went to a doctor in the US. I found him through the WPATH network (The World Professional Association for Transgender Health). Nicki was 13 when she started taking hormone blockers. It’s put her male puberty on hold, and given her time to think.

“If she hadn’t been given blockers, she would have suffered the psychological agony of going through male puberty. She told me she would have killed herself. Nowadays, you’d never guess that she was born male.

“If at any point Nicki were to tell me that she wasn’t sure that this was the right thing for her, we’d simply stop the injections and male puberty would go ahead.

“For Nicki, the next step is starting hormones and surgery as soon as she can.

“During the first few years of secondary school, I was constantly in fear for Nicki’s life. It was so distressing to watch her go through all of this.

“Now it’s a million times better. She’s a typical teenage girl, and it’s a blessing. She leaves a mess, she borrows my clothes, my make-up and my perfume. I never thought she’d reach this stage. She still has to face many more hurdles but she’s looking forward to adulthood.”

*The names in this article have been changed.

Where to Get Help

Sharon, who tells her story above, says that the most helpful thing was speaking to other families who’ve been through the same thing. The charity Mermaids provides family support for children and teenagers with gender identity issues, and can put you in touch with other parents with similar experiences.

Further Information

The story above reflects one mother’s experience. Because gender identity issues are complex and each case is different, Sharon’s story shouldn’t be seen as typical.

For more information on gender identity issues in children and young people, see: Teenagers and gender identity, and Worried about a child with gender identity issues?

Editor’s Note: *clarification provided for our US readers.





Research Reveals the Myth of Family Dinner Time as Cure-all

benefits-of-family-dinnersThe clock is approaching 6:00 pm and your household is frazzled. Half the kids are still at soccer practice. You have to pick them up in 20 minutes. The younger kids are in “witching hour” mode and running around crazy and begging for snacks. You haven’t yet considered what will be on the menu for dinner.

Does this sound like your house? Many times family dinner time can easily turn into stressful time. Yet, we hear all the time that families who eat dinner together reap great benefits for themselves and their children.

Most of us have heard all the research about how important family dinners are to kids’ long-term outcomes. Just a few years ago, journalist and filmmaker Miriam Weinstein wrote a book entitled, The Surprising Power of Family Meals: How Eating Together Makes Us Smarter, Stronger, Healthier, and Happier, in which she outlines the research that supports the role that family dinners play in kids’ lives.

Reading this research, it really sounds like family dinners are the magic bullet of family life. Family dinners have been associated with all sorts of positive outcomes for kids, such as less teenage delinquency and drug use, lower rates of obesity, greater emotional stability, and even better preparedness for reading. It sounds a little too good to be true. Something as simple as family dinners could make all these great outcomes appear in your family?

Well, it turns out that the “magic bullet” of the family dinner may be a little too good to be true. New research is delving deeper into the role that family dinners play in the lives of children. This research is not only compelling because of the insight it offers into family life, but it also illustrates a perfect example of the difference between correlation and causation in social science research.

In this new research, scientists used a huge national survey of adolescents. They consider the relationship between family dinners and three main outcomes:

  • Teen depression,
  • Teen alcohol and drug use, and
  • Teen delinquency

At first, the study seemed to replicate previous work, with there being a strong correlation between family dinners and less teen delinquency. Then, however, researchers went one step further.

They controlled statistically for other factors that might explain these differences in families such as:

  • How well parents monitor their children,
  • How many activities parents do with their children, and
  • Family resources

Not surprisingly, when these factors are included in the mix, the correlation between family dinners and teen outcomes drops dramatically. In other words, these other factors, not family dinner itself, can explain much of the effects we see. Family dinner time is “masking” these other factors.

So it turns out that family dinners are not the “magic bullet” that they were once considered to be. As is often the case in social science, the strong correlation between family dinners and teen outcomes did not mean that family dinners were the sole cause of this relationship. As this new research shows, the family dinner is really just a proxy for other positive things parents do with their children such as talking and engaging with them on a daily basis. The key component that seems to be influencing kids is this: connection and communication with parents.

Does this mean that you should give up on family dinners? Of course not!

Dinner time is still a great opportunity to connect with you kids, but it’s not the only way. In his popular book, The Secrets of Happy Families: Improve Your Mornings, Tell Your Family History, Fight Smarter, Go Out and Play, and Much More, Bruce Feiler discusses different ways in which families can connect throughout the day, not just a dinner.

Here are just a few ideas:

  • If after school activities make dinner time difficult, have an early “dinner” at 4:00 for all who can join. Then later at night, have a family dessert for everyone.
  • Family time does not always have to center around a meal—how about a walk when everyone gets home from school and work.
  • Family storytelling and asking kids questions is key. Every family has stories from grandparents or funny tales from relatives.
  • Start a “themed” conversation that happens most times the family is together. Ours is sharing “joys and challenges” of the day or week. Each person shares something that was a “joy” and “challenge” for that day. It is amazing all the good conversation this can start.

Research is clearly showing that “family dinner” is really just a proxy for family connection. Kids that feel safe, connected, and valued by their family are less likely to participate in dangerous activities like drug use, extreme risk-taking or delinquent acts. Furthermore, these kids tend to be happier and are less likely to be depressed.

Take the pressure and stress out of family dinner. Just aim to find a few minutes every day to connect with your family, in any way you can.

Study: ADHD Meds Given More Often to Youngest Kids in Class

“Youngest children in class more likely to get ADHD medication, study says,” The Guardian reports.

The results of an Australian study have caused concerns that, in some cases, immature behaviour may be misinterpreted as evidence of a behavioural disorder.

In a brief report, researchers found nearly 2% of 6-15-year-olds in Western Australia received a prescription for attention deficit hyperactivity disorder (ADHD) medication in 2013. Those born in the last months of the school year intake were more likely to have had a prescription than the oldest children in the year.

The gap between the oldest and youngest children in the class had a small, but significant, association with the increased use of ADHD medications. The researchers say their findings compare with those of other international studies.

It’s possible the youngest children in a school year may find it harder to keep up in lessons than children almost a year older than them, and may be more likely to have problems with concentration.

But it would be a big assumption to say ADHD is being overdiagnosed and overtreated on the grounds of this study alone.

The use of ADHD medication for under-16s in the UK is far lower than in many other developed nations – 0.4%, compared with Australia’s 1.9% or the US’ 4.4% – so the potential problem of inappropriate treatment may not be as much of an issue in this country.

Where did the story come from?

The report was authored by four researchers from Curtin University, Murdoch University and the University of Western Australia, all in Australia.

The study was published in the peer-reviewed Medical Journal of Australia, and the researchers declared no conflict of interest or study funding.

It’s available to read online on an open access basis, so you can download the study for free.

The UK media coverage was accurate, but does not point out the limitations of this brief report.

What kind of research was this?

In this brief one-page report, the researchers say four international studies found the youngest children in a school year are more likely to be receiving ADHD medication.

They aimed to see how Western Australia compares by analysing data from the Pharmaceutical Benefits Scheme – a scheme similar to the NHS, where the cost of medicine is subsidised by the Australian government – to see how many children were receiving ADHD medication.

This brief report provides very limited information about the authors’ methods, making it difficult to critique.

And we don’t know how the authors identified the four international studies they reported, so we don’t know whether this is a fully comprehensive look at the subject.

This means the report must largely be considered to be the opinion of its authors.

What did the researchers do?

The researchers compared the proportion of children born in the first and last months of a “recommended school year intake” who were recorded in the Pharmaceutical Benefits Scheme as receiving at least one prescription for ADHD medication in 2013.

The study included a total of 311,384 children, covering two age bands: those aged 6-10 (born July 2003 to June 2008) and those aged 11-15 (born July 1998 to June 2003).

The researchers looked at the number of children receiving medication and the patterns by time of birth.

What did they find?

The researchers found 1.9% of the full study sample (5,937 children) had received at least one prescription of ADHD medication, with more boys than girls being prescribed for (2.9% versus 0.8%).

In the 6-10-year-olds, they found those born in the last month of the school year intake (June) were nearly twice as likely to have been prescribed medication as those born in the first month (the previous July): relative risk (RR) 1.93 for boys (95% confidence interval [CI] 1.53 to 2.38) and RR 2.11 for girls (95% CI 1.57 to 2.53)

The same pattern was seen for 11-15-year-olds, but the risk increase was less, though still significant (RR 1.26, 95% CI 1.03 to 1.52 for boys; RR 1.43, 95% CI 1.15 to 1.76 for girls).

The authors say similar effects were also seen when comparing those in the first three to six months of intake with the last three to six months.

What did the researchers conclude?

The researchers say at 1.9%, their observed prescription rate is comparable to a recent Taiwanese study, and both this study and three North American studies observed the effects of birth month on prescription rates.

They describe a professional from the American Psychiatric Association who feels ADHD is overdiagnosed and overmedicated, saying that, “Developmental immaturity is mislabelled as a mental disorder and unnecessarily treated with stimulant medication.”

The authors say the findings indicate that, “Even at relatively low rates of prescribing, there are significant concerns about the validity of ADHD as a diagnosis.”

Conclusion

Overall, this study suggests that in Western Australia – and reportedly in other countries, too – the youngest children in a given school year are more likely to be diagnosed with and treated for ADHD than the eldest in the year.

However, it’s important not to draw too many conclusions from this brief report. The authors provide very limited information about their methods, so it’s not possible to critique how they conducted their study.

We don’t know why they selected the 2013 school year, for example. It was said to be recommended, but we don’t know why. It could be it was known there were an unusually high number of prescriptions noted in the Pharmaceutical Benefits Scheme that year, which means it might not be representative.

Also, this database can only tell us the number of children that filled out at least one prescription for ADHD medication. We don’t know how the children were diagnosed, how long they had been diagnosed or treated for, or whether they actually took the medication.

The authors also point out the possible limitation that they didn’t know how many children may have entered school outside of their recommended starting year – although this was thought to be few.

We also don’t know how the researchers identified the international studies, and we don’t know that these reported findings give a comprehensive look at ADHD diagnosis and treatment worldwide.

It would be a big assumption to say ADHD is being overdiagnosed and overtreated on the grounds of this study alone. And, as no UK studies were reported, we don’t know what the true situation is like in this country.

It’s possible the youngest children in a school year may find it harder to keep up with lessons than children almost a year older than them, and so could be more likely to be distracted – though this is clearly a big generalisation and is not always going to be the case.

However, it does perhaps highlight there is a need for children who are struggling or finding it difficult to concentrate at school to be recognised, and get the additional attention and support they need – something both teachers and parents of the youngest children in a school year may need to be aware of.

Analysis by Bazian. Edited by NHS Choices

Links to the Headlines

Links to the Science





How to Cope with Teen Arguments, Aggression and Violence

Many parents find that when their child becomes a teenager, their behaviour becomes more challenging. But how do you cope if they become aggressive or even violent towards you?

If you’re experiencing aggression or violence from your teen, you’re not alone. A recent Parentline Plus survey found that 60% of calls (between October 2007 and June 2008) included verbal aggression from a teenager, and 30% involved physical aggression, much of it aimed at the parent themselves.

teen aggression and violenceIt is common to keep this kind of abuse behind closed doors and not confide in anyone. Many parents feel  that they have failed to control their child, or that they are responsible for the behaviour in some way – or they may not know where to turn.

However, any kind of aggression can be stressful, and can cause an atmosphere of tension and fear for the entire family, not to mention the possibility of physical harm if their teen becomes violent.

No parent should feel obliged to put up with an unruly teen, and as with any type of domestic abuse, help and support is available. You can find appropriate organisations and helpline numbers (*for the UK)  in “Help and Support” further below. There are also a number of techniques and tips that you might find helpful.

Defusing Heated Arguments

It’s useful to remember that your own behaviour can improve or worsen an aggressive situation, so it’s important to be a good role model for your teen.

Linda Blair, clinical psychologist working with families, advises: “Bear in mind that you are their principal role model. If you act aggressively but tell them not to, they won’t listen. It’s also helpful to remember that their anger is often based on fear – fear that they’re losing control.”

With that in mind, it is worth trying to maintain a calm and peaceful presence. You need to be strong without being threatening. Remember that your body language, as well as what you say and how you say it, should also reflect this.

Avoid staring them in the eye, and give them personal space. Allow them the opportunity to express their point of view, then respond in a reasoned way.

Breathing Exercises to Control Anger

If an argument becomes very heated, Linda suggests that you “stop for a moment”. Take a deep breath, hold it for a few seconds and then exhale. Repeat five times. This technique is very useful in intense situations.

If your teen is becoming aggressive during arguments, suggest this technique to them when they’re calm, so they too have a way of controlling their anger.

If an argument feels out of control, you can also try explaining to them that you are going to walk away, and that you’ll come back again in half an hour. Given the chance to reflect and calm down, you and your teen will both be more reasonable when you resume your discussion.

As with toddlers, if you give in to teenagers because their shouting and screaming intimidates or baffles you, you are in effect encouraging them to repeat the unreasonable behaviour as a way of getting what they want.

Counselling for Teenagers

Family Lives is a charity dedicated to helping families. They suggest that if very heated arguments happen frequently, it may be worth suggesting counselling to your teen. They’ll benefit from talking to someone new and unbiased, someone who isn’t in their family and who won’t judge them.

Read more about the benefits of talking treatments.

Remember they may not know how to handle their anger, and this can leave them frustrated and even frightened. Some guidance from an outsider can be very helpful.

Dealing with Violent Behaviour

Sometimes, teen aggression can turn into violence. If they lash out at you, or someone or something else, put safety first.

Let your teenager know that violence is unacceptable and you will walk away from them until they’ve calmed down. If leaving the room or house isn’t helping, call the police – after all, if you feel threatened or scared, then you have the right to protect yourself.

Family Lives offer this advice for coping with, and helping, a violent teen:

  • Give them space – once they have calmed down, you may want to talk to them about what has happened and suggest that they let you find them some help.
  • Be clear – teenagers need to know that you will stand by the boundaries you set. They need to know that any kind of violence is unacceptable.
  • Talk to their school and find out if their aggressive behaviour is happening there as well. Some schools offer counselling.
  • Arrange counselling – if your teen admits they have a problem and is willing to get help, book an appointment with a counsellor or psychologist as soon as possible. Speak to your GP (*pediatrician  or family doctor) or their school about what help is available.

Help and Support (*in the UK – see end for resources in other locations)

There are many organisations that offer emotional support and practical advice. Getting some support can help you and your child. At such an important development stage, it’s important that they learn how to communicate well and express anger in a healthy way.

  • You can call Family Lives’ Parentline on 0800 800 2222 any time, or email parentsupport@parentlineplus.org.uk for a personalised reply within three days. They also offer i-parent modules to help you learn more about communicating better with your teen.
  • You can call the Samaritans on 08457 909090 any time to talk about any type of distress and to get confidential support and advice.
  • Youth Access has details about youth organisations and services offering teens counselling, advice and support.
  • Young Minds is a charitable organisation supporting children and young people with mental health issues, and their parents. They provide information to help young people with anger issues. If you discuss your child’s behaviour with them and they are open to getting help, you might like to direct them to the information on the Young Minds website.

Concerned about Mental Health Issues?

If you’re worried that your teen has a mental health problem such as depression, talk to your GP (*pediatrician  or family doctor). In the UK, he or she can refer them to the Child and Adolescent Mental Health Services, who in turn can refer all or some of you for Family Therapy. Or contact the Young Minds Parents’ Helpline on 0808 802 5544 for advice and support concerning mental health issues in young people.

If you are having trouble coping with your teenager, and you suspect you may have symptoms of depression or other mental health problems, discuss this with your GP (*pediatrician  or family doctor). He or she can then suggest suitable treatment. You may, for example, be referred for counselling, or directed to support groups or other services in your area.

Editor’s Note: *clarification provided for our US readers.

US Resources for Family and Teen Challenges:

Canadian Resources for Family and Teen Challenges:

Australian Resources for Teen Aggression:

 





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