Category Archives: borderline personality disorder

Take this parenting test if you have a troubled teenager

Take this parenting test if you have a troubled teenager
1 votes

So how are you doing in this parenting job you have?  Score your parenting skills on a test designed for parents of children ages 11-15 with serious behavior problems.  (If you are brave, have someone else score you too and compare notes.)

Always: 5    Generally: 4    Sometimes: 3    Rarely: 2    Never: 1 Your
score
1.    My child’s other parent (or caregiver) and I agree on how to discipline our child.  


2.    My child can depend on me to do what I say I will.
3.    When I say “no”, I stick to it.
4.    I treat my child with respect, even when I’m angry.
5.    I let natural consequences do the teaching whenever feasible.
6.    I am confident my child has everything she/he needs to make
good decisions.

7.    I allow my child to do his/her chores without my reminding.
8.    I allow my child to voice her/his opinions when done in a
respectful way.

9.    I am able to stay out of arguments by disengaging before they
escalate.

10: When I make a mistake in judgment, I’m quick to admit it.
TOTAL

SCORE

45 – 50   Good job!  You are on the right track.
30 – 45   Not bad, just a little more work in those challenging areas.
Less than 30  Keep trying!  Find a support group; a therapist for you and a co-parent; or books (recommendation).

Don’t be hard on yourself if you score low.
Teenagers are difficult.

You might be thinking:  “I agree these are good parenting skills, but practicing them is impossible with my child.  They hate/defy/scream at me constantly.”  Advice: Work on one at a time, and check back in few weeks to see if you’ve improved your score.

This test is drawn from a parenting guide created in 2007 by StandUp Parenting (www.standup.org)
to help parents understand what is needed to maintain authority and model maturity.  

Please add a comment if you have found other skills to be effective,

Margaret

 

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What to know about psychiatric residential treatment

What to know about psychiatric residential treatment
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residential centerHave you been searching for psychiatric residential treatment for your child?  Do all the programs sound wonderful?  Ads include quotes from happy parents, and lovely photos and fabulous-sounding activities.  But what’s behind the ads?  Residential treatment programs are diverse, but there are important elements they should all have.  Here’s how to avoid low quality residential treatment.

Psychiatric residential treatment is serious stuff–it’s difficult to do–especially when troubled children and teens are put together in one facility.

Should you ask other parents for their opinion of a program?  In my experience with a child in psychiatric residential care, and as a former employee of one, word-of-mouth is not the best way to assess quality or success rate.  There are too many variables: children’s disorders are different; acuity is different; parents’ attitudes and expectations are different; length of time in the facility is different; what happens once a child returns home is different…  It’s most helpful to ask questions of intake staff and doctors or psychologists on staff.  Quality psychiatric residential care facilities have important things in common.

What to ask about the staff:

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  • What is the training and licensure of staff?  Are there therapists with MSW degrees, registered nurses, psychiatrists and psychiatric nurse practitioners, and is a medical professional available on site 24/7?
  • There should be a high staff to patient ratio, and a physically comfortable environment with lots of emotional support.
  • Do the staff seem mature to you?  Do they support each other, are they a team?  There is often heavy staff turnover at residential treatment centers because the work is emotionally draining, so staff cohesion is as important as the qualities of each individual.
  • Safety is paramount.  Staff must be able to safely manage the things that can go wrong with troubled kids.  They should be trained in NCI (Nonviolent Crisis Intervention), “training that focuses on prevention and offers proven strategies for safely defusing anxious, hostile, or violent behavior at the earliest possible stage.”

What to ask about programs:

  • Does the program specifically identify parent/family involvement as part of treatment?  Does it emphasize parent partnership with staff?  Ask.  Whether you live close or far from the center, even out-of-state, you should be regularly included in conversations with staff about your child’s treatment.  You should also be included in a therapy session with your child periodically; some facilities can connect with you over Skype.  Your child’s success in psychiatric care depends on their family’s direct involvement.
  • The program should coach you in specific parenting approaches that work for child’s behavioral needs.  While your child is learning new things and working on their own changes, you must also.
  • You should be informed why your child is getting the treatment or behavioral modifications he/she is receiving.

Body health is mind health, and vice versa.

  • residential programsMental health treatment will include medication and therapy, but must also include positive activities and an educational program.  The whole body needs care:  exercise, social activities, therapeutic activities (art, music, gardening), healthy food, restful sleep, etc.

Is your child emotionally safe as well as physically safe?

  • You should be able to visit the unit or cottage where your child will live, see their bedroom, and see how the other children interact with staff and how staff interact with each other.

What to ask about the business itself:

  • Can you take a tour ahead of time?  Can your child or teen visit too if appropriate?
  • Are emergency services nearby (hospital, law enforcement) that can arrive quickly?
  • Does the facility have a business license in their state?  Do they have grievance procedures?  Is the center accredited as a treatment facility, and by whom?  In the U.S., the main accreditation authority is called JCAHO (Joint Commission on Accreditation of Healthcare Organizations).

Psychiatric residential treatment works miracles, but it doesn’t work for all children.  Some need to go into treatment more than once to benefit. Some fall apart a few weeks or months after discharge.  These are common.  What’s important is that you and your child are taught skills for managing his or her unique symptoms, communicating well, and committing to staying well together.

Good luck.

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Brace yourself for borderlines

Brace yourself for borderlines
16 votes

Are you ready to bang your head on a wall?  Do you want to abandon your child in the wilderness?  Are you praying for the day they turn 18, when you can change the locks on your doors?  Children with borderline personality disorder (BPD) bring out the worst in everyone around them.

A borderline child or teen is not a “drama junkie” on purpose.  There brain is primed to overreact.

Yes, BPD kids really believe that others are out to get them, and that all their problems are someone else’s fault.  They are appalled that others mistreat them horribly.  They are insulted and defensive when they detect criticism, even when there isn’t any.  They can never be pleased, and it’s always about them.  Most exasperating for you, they turn from monstrous, to sweet and charming, and back to monstrous in an instant.

“Does this explain why I can go from 0 to 60 in two seconds?”
–17-year-old girl when told she was diagnosed with borderline personality disorder

Especially confusing, a borderline teen can be very engaging and affectionate… sometimes at random, and sometimes when they want something.  They will also turn on the charm to embarrass you in front of others (such as in family therapy).  Since they seem so wonderful to other people, you are asked why you get upset at your clearly wonderful child.  People often recommend that you take care of your own issues instead.

Even though their manipulation and upheaval is relentless, strive for compassion.  Trust me, your borderline child will suffer more than you in every important aspect of life.  They make a mess of their relationships because of their anger, instability, substance abuse.  Their clingy behavior is annoying.  They drive away good friends, hate them for leaving, and then suffer from loneliness and depression.  They make a mess of their jobs, often fired or forced to resign, and bounce from one to another… and they don’t understand why it happens to them.

For goodness sakes, why?

When playing a game that requires teamwork, the brain of a normal person shows activity in the bilateral anterior insula.

 

The brain of a borderline person, when playing the teamwork game, showed no activity whatsoever.

A study published in 2008 in Science showed that brain activity in people with borderline personality disorder was abnormal—their brains lack activity in the ‘cooperation’ and ‘trust’ regions, called the bilateral anterior insula.  Borderline personality patients do not have an internal, natural sense of fairness and social norms, and little to no level of trust.

Statistics

One research study reported that borderline personality disorder occurs as often in men and women, and sufferers often also have other mental illnesses or substance abuse problems.  (In my personal observations over many years, teenagers with borderline personality disorder are often diagnosed with bipolar disorder.) Another study reported, “The disorder occurs in all races, is prevalent in females (female-to-male ratios as high as 4:1), and typically presents by late adolescence.”  It is estimated 1.4 percent of adults in the United States have this disorder.

In infants:  the children who were later diagnosed with borderline personality were more sensitive, had excessive separation anxiety and were moodier. They had social delays in preschool and many more interpersonal issues in grade school, such as few friends and more conflicts with peers and authorities.

In teenagers:  they are more promiscuous, aggressive and impulsive, and more likely to use drugs and alcohol. Cutting and suicide are more common.  “…research shows that, by their 20s, people with the disorder are almost five times more likely to be hospitalized for suicidal behavior compared to people with major depression.”

 

Evidence for hope

“Trying to Weather the Storm” (excerpt)
Shari Roan, September 07, 2009, Los Angeles Times

“Borderlines have the thinnest skin, the shortest fuses and take the hardest knocks.  In psychiatrists’ offices, they have long been viewed as among the most challenging patients to treat.

“But almost 20 years after the designation of borderline personality disorder, understanding and hope have surfaced for people with the condition and their families.  Advances have been made in recent years.  Researchers from McLean Hospital in Massachusetts studied 290 hospitalized patients with the condition over a 10 year period:  93 percent of patients achieved a remission of symptoms lasting at least two years, and 86 percent for at least four years. Published in The American Journal of Psychiatry, the research argues that once recovery has been attained, it appears to last.

“Having a relative with BPD can be hell,” says Perry D. Hoffman, president of the National Education Alliance for BPD http://www.borderlinepersonalitydisorder.com.  “But our message to families is to please stay the course with your (child) because it’s crucial to their well-being.”

Treatment

“What Therapy Is Recommended for Borderline Personality Disorder in Adolescents (13-17 years)?”(excerpt)
Mary E. Muscari, PhD, August 9, 2005, http://www.medscape.com/viewarticle/508832

Psychotherapy is the primary treatment of BPD, specifically long-term dialectical behavior therapy (DBT), which helps the person attain and maintain lasting improvement in their personality, interpersonal problems, and overall functioning.  DBT appears to be the most effective.  It focuses on coping skills, so patients learn to better control their emotions and behaviors. This may be complemented with medications that help with mood stability, impulsivity, psychotic-like symptoms, and self-destructive behavior.

There are several appropriate therapies in addition to DBT, and all share common elements:  1. The bond between the patient and therapist is strong.  2. Therapy focuses on the present rather than the past, on changing one’s behavior patterns now regardless of how patients feel about the past or if they see themselves as victims.

On DBT:  I recommend this straightforward self-help lesson to get started learning the concepts and skills:  http://www.dbtselfhelp.com/html/dbt_lessons.html.

When to hospitalize

  • In an emergency – when your child has serious suicidal thoughts or an attempt, and/or is in imminent danger to others.
  • In long-term residential care – when your child has persistent suicidal thoughts, is unable to participate in therapy, has a life-threatening mental disorder (e.g. bipolar), continued risk of violent behavior, and other severe symptoms that interfere with living.

Other treatment a borderline may need:

  • Treatment for substance abuse.
  • Therapy that focuses on violent and antisocial behaviors, which can include emotional abuse or physical abuse, baiting, bullying, and sexualized behaviors.
  • Therapy that focuses on trauma and post traumatic issues when an adolescent loses their sense of reality.
  • Reduce stressors in the young person’s environment.  Most adolescents with BPD are very sensitive to difficult circumstances, for examples: an emotionally stressful atmosphere at home; teasing in school; pressures to succeed or change; consistent rules; being around others who are doing better than them, etc.

What parents and caregivers can do

With a partner or spouse:  Maintain a united front.  Communicate continually to stay on the same page when managing your child and setting limits.  Have each other’s back even if you’re not in full agreement.  Always take disagreements out of earshot of your child.  Any disagreement they hear will be used against you.

Maintain family balance.

Keep your energy in balance so you can maintain your family's foundation.  Too much spent on your child affects everything else your family needs to survive.

Keep your energy in balance so you can maintain your family’s foundation. Too much spent on your child affects everything else your family needs to survive.

 

Keep things relaxed.  If you need to set boundaries and apply pressure, do it only to maintain  appropriate behaviors and reminders for self-calming.  Let other things go.

Use praise proactively.  Borderlines crave attention and praise.  When they deserve it, pour it on thick.  And pour it on thick every single time they demonstrate good behavior and positive intention.  One can’t go too far.  When an argument or fight comes up, search your memory banks for the most recent praiseworthy thing they did or said, and bring it up and again express your gratitude and admiration.  This does two things:  it reinforces the positive;  and it redirects and ends a negative situation.

Become skilled in DBT and help your child stay in the here and now.  Keep up the reminders that enable them to stay in the moment, to take those extra few seconds to think things through before reacting.

  • Did your friend really intend to upset you?  It sounds like they were talking about something else.
  • The delay wasn’t planned just to make you mad, perhaps you were just frustrated by being asked to wait, and it was no one’s fault.
  • The tear in your jacket isn’t a catastrophe.  It is easily fixed and I can show you how.

Prevent dangerous risk taking – Teens with borderline personality are exceptionally impulsive and prone to risky behavior.  Consequently, parents should consider:

  • Tightly limiting cell phone use, email, texting, and access to social networking sites
  • Using technology to track their communications (this is legal), or disabling access during certain time periods
  • Reducing the amount of money and free time available
  • Searching their room (this is also legal)

A couple I know fully informed their borderline teen that all internet activity would be tracked, as well as cell phone calls.  The father also installed cameras in the home, at the front and back doors, in plain sight.  Nevertheless, his son continued with bullying and hurtful behavior towards siblings right in front of those cameras, and he would get caught and pay consequences repeatedly.  His persistence in the face of obvious monitoring became a great source of private amusement for his parents–humor really does provide relief.
–Margaret

Be patient – You are unlikely to receive the child’s respect, love, or thanks in the short-term.  It may take years.  But be reassured that your child will thank you for your firm guidance and limits once he or she matures to adulthood.

Other characteristics of BPD

Signs and symptoms of BPD may include significant fear of real or imagined abandonment; intense and unstable relationships that vacillate between extreme idealization and devaluation; markedly and persistently unstable self-image; significant and potentially self-damaging impulsivity (spending, sex, binge eating, gambling, substance abuse, and reckless driving); repeated suicidal behavior, gestures, or threats; self-mutilation (carving, burning, cutting, branding, picking and pulling at skin and hair, biting, and excessive tattooing and body piercing); persistent feelings of emptiness; inappropriate anger or trouble controlling anger; and temporary, stress-related severe dissociative symptoms or paranoid ideation.

  • Chronic depression: Depression results from ongoing feelings of abandonment.
  • Inability to be alone: Chronic fear of abandonment also leads to these adolescents having little tolerance for being alone. This results in a constant search for companionship, no matter how unsatisfying.
  • Clinging and distancing: Relationships tend to be disruptive due to the adolescents’ alternating clinging and distancing behaviors. When clinging, they may exhibit dependent, helpless, childlike behaviors. They over idealize he person they want to spend all their time with, constantly seeking that person out for reassurance. When they cannot be with their chosen person, they exhibit acting-out behaviors, such as temper tantrums and self-mutilation. Distancing is characterized by anger, hostility, and devaluation, usually arising from discomfort with closeness.
  • Splitting: Splitting arises from the adolescents’ inability to achieve object constancy and is the primary defense mechanism in BPD. They view all people, including themselves, as either all good or all bad.
  • Manipulation: Separation fears are so intense that these adolescents become masters of manipulation. They will do just about anything to achieve relief from their separation anxiety, but their most common ploy is to play one individual against another.
  • Self-destructive behaviors: The behaviors are typically manipulative gestures, but some acts can prove fatal. Suicide attempts are not uncommon yet usually happen in relatively safe scenarios, such as swallowing pills at home while reporting the deed to another person on the telephone.
  • Impulsivity: Poor impulse control can lead to substance abuse, binge eating, reckless driving, sexual promiscuity, excessive spending, or gambling. These behaviors can occur in response to real or perceived abandonment.

 

Drawn from:
Risk taking adolescents: When and how to intervene (excerpt)
David Husted, MD, Nathan Shapira, MD, PhD , 2004
University of Florida College of Medicine, Gainesville

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How am I doing?  Please rate this article at the top, thanks!

–Margaret

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Spirituality and mental health, some research

Spirituality and mental health, some research
10 votes

Scientists worldwide have been studying the effect of religion and spirituality on mental health and addiction recovery in children, teens, and adults.  Below are research findings that show religion and spirituality improve adult and adolescent mental health, including recovery from mental crises and substance abuse, when the spiritual approach carries messages of love, kindness, tolerance, and moral responsibility.  But when religion had a punitive or unforgiving message to those with mental or substance abuse disorders, the results were disheartening: a worsening of psychotic symptoms; inability to sustain recovery from substance abuse; and physical abuse.

If you look at the dates of some of these studies, you’ll see that researchers have been measuring of the value of spirituality for mental health and addiction for ~30 years, and results have consistently shown positive benefits which are statistically significant.  It’s hard core research–dense reading–so key findings and conclusions are in red in case you don’t want to scan through lengthy writing and jargon.

Enjoy,  Margaret

– – – – – – – – – –

God Imagery and Treatment Outcomes Examined
Currier JM, Foster JD, Abernathy AD, et al. God imagery and affective outcomes in a spiritually integrative inpatient program. [Published online ahead of print May 5, 2017]. Psychiatry Res. doi:10.1016/j.psychres.2017.05.003.

Patients’ ability to derive comfort from their religious faith and/or spirituality emerged as a salient mediating pathway between their God imagery at the start of treatment and positive affect at discharge, a recent study found. Drawing on a combination of qualitative and quantitative information with a religiously heterogeneous sample of 241 adults who completed a spiritually-integrative inpatient program over a 2-year period, researchers tested direct and indirect associations between imagery of how God views oneself, religious comforts and strains, and affective outcomes.

FINDINGS

When accounting for patients’ demographic and religious backgrounds, structural equation modeling results revealed:
(1) overall effects for God imagery at pre-treatment on post-treatment levels of both positive and negative affect;
(2) religious comforts and strains fully mediated these links.

Secondary analyses also revealed that patients generally experienced reductions in negative emotion in God imagery over the course of their admissions.

“[Spirituality] enables neurotic conflicts typical for adolescence to be more easily overcome.”

The influence of religious moral beliefs on adolescents’ mental stability.
Pajević I, Hasanović M, Delić A., : Psychiatry Danub. 2007 Sep;19(3):173-83

University Clinical Centre Tuzla, Trnovac b.b, 75 000 Tuzla, Bosnia & Herzegovina. zikjri@bih.net.ba.
This study included 240 mentally and physically healthy male and female adolescents attending a high school, who were divided into groups equalized by gender (male and female), age (younger 15, older 18 years); school achievement (very good, average student); behaviour (excellent, average); family structure (complete family with satisfactory family relations), and level of exposure to psycho-social stress (they were not exposed to specific traumatizing events).  Subjects were assessed with regard to the level of belief in some basic ethical principles that arise from religious moral values.

CONCLUSIONS: A higher index of religious moral beliefs in adolescents enables better control of impulses, providing better mental health stability.  It enables neurotic conflicts typical for adolescence to be more easily overcome.  It also causes healthier reactions to external stimuli.  A higher index of religious moral beliefs of young people provides a healthier and more efficient mechanism of anger control and aggression control.  It enables transformation of that psychical energy into neutral energy which supports the growth and development of personality, which is expressed through socially acceptable behaviour.  In this way, it helps growth, development and socialization of the personality, leading to the improvement in mental health.

Religion, Stress, and Mental Health in Adolescence: Findings from Add Health

Nooney, J. G. 2008-10-23 from http://www.allacademic.com/meta/p106431_index.html

 A growing body of multidisciplinary research documents the associations between religious involvement and mental health outcomes, yet the causal mechanisms linking them are not well understood.  Ellison and his colleagues (2001) tested the life stress paradigm linking religious involvement to adult well-being and distress.  This study looked at adolescents, a particularly understudied group in religious research.  Analysis of data from the National Longitudinal Study of Adolescent Health (Add Health) reveals that religious effects on adolescent mental health are complex.  While religious involvement did not appear to prevent the occurrence of stressors or buffer their impact, some support was found for the hypothesis that religion facilitates coping by enhancing social and psychological resources.

 

Study Links Religion and Mental Health

David H. Rosmarin and Kenneth Pargament, Bowling Green State University, Ohio

(IsraelNN.com) 2008

A series of research studies – known as the JPSYCH program – reveals that traditional religious beliefs and practices are protective against anxiety and depression among Jews.  The research indicates that frequency of prayer, synagogue attendance, and religious study, and positive beliefs about the Divine are associated with markedly decreased levels of anxiety and with higher levels of happiness.  “In this day and age, there is a lot to worry about,” Rosmarin notes, “and the practice of religion may help people to maintain equanimity and perspective.”

 

The Once-Forgotten Factor in Psychiatry: Research Findings on Religious Commitment and Mental Health (excerpt)

David B. Larson, M.D., M.S.P.H., Susan S. Larson, M.A.T., and Harold G. Koenig, M.D., M.H.Sc.

Psychiatric Times.  Vol. 17 No. 10, October 1, 2000

 

“The data from many of the studies conducted to date are both sufficiently robust and tantalizing to warrant continued and expanded clinical investigations.”

 

Treatment of Drug Abuse

  • The lack of religious/spiritual commitment stands out as a risk factor for drug abuse, according to past reviews of published studies.  Benson (1992) reviewed nearly 40 studies documenting that people with stronger religious commitment are less likely to become involved in substance abuse.
  • Gorsuch and Butler (1976) found that lack of religious commitment was a predictor of drug abuse.  The researchers wrote:  “Whenever religion is used in analysis, it predicts those who have not used an illicit drug regardless of whether the religious variable is defined in terms of membership, active participation, religious upbringing or the meaningfulness of religion as viewed by the person himself.”
  • Lorch and Hughes (1985), as cited by the National Institute for Healthcare Research (1999), surveyed almost 14,000 youths and found that the analysis of six measures of religious commitment and eight measures of substance abuse revealed religious commitment was linked with less drug abuse.  The measure of “importance of religion” was the best predictor in indicating lack of substance abuse.  The authors stated, “This implies that the controls operating here are deeply internalized values and norms rather than fear or peer pressure.”
  • Developing and drawing upon spiritual resources can also make a difference in improving drug treatment.  For instance, 45% of participants in a religious treatment program for opium addiction were still drug-free one year later, compared to only 5% of participants in a nonreligious public health service hospital treatment program-a nine-fold difference(Desmond and Maddux, 1981).
  • Confirming other studies showing reduced depression and substance abuse, a study of 1,900 female twins found significantly lower rates of major depression, smoking and alcohol abuse among those who were more religious (Kendler et al., 1997).  Since these twins had similar genetic makeup, the potential effects of nurture versus nature stood out more clearly.

“lack of religious commitment was a predictor of drug abuse”

Treatment of Alcohol Abuse

  • Religious/spiritual commitment predicts fewer problems with alcohol (Hardesty and Kirby, 1995).  People lacking a strong religious commitment are more at risk to abuse alcohol (Gartner et al., 1991).  Religious involvement tends to be low among people diagnosed for substance abuse treatment (Brizer, 1993).
  • A study of the religious lives of alcoholics found that 89% of alcoholics had lost interest in religion during their teen-age years, whereas 48% among the community control group had increased interest in religion, and 32% had remained unchanged (Larson and Wilson, 1980).
  • A relationship between religious or spiritual commitment and the non-use or moderate use of alcohol has been documented.  Amoateng and Bahr (1986) reported that, whether or not a religious tradition specifically proscribes alcohol use,those who are active in a religious group consumed substantially less alcohol than those who are not active.
  • Religion or spirituality is also often a strong force in recovery.  Alcoholics Anonymous (AA) invokes a Higher Power to help alcoholics recover from addiction.  Those who participate in AA are more likely to remain abstinent after inpatient or outpatient treatment(Montgomery et al., 1995).

“…adolescents [who were] frequent church-goers with high spiritual support had the lowest scores on the Beck Depression Inventory.”

Suicide Prevention – Surging suicide rates plague the United States, especially among adolescents.  One in seven deaths among those 15 to 19 years of age results from suicide.

  • One study of 525 adolescents found that religious commitment significantly reduced risk of suicide(Stein et al., 1992).
  • A study of adolescents found that frequent church-goers with high spiritual support had the lowest scores on the Beck Depression Inventory(Wright et al., 1993).  High school students of either gender who attended church infrequently and had low spiritual support had the highest rates of depression, often at clinically significant levels.
  • How significantly might religious commitment prevent suicide?  One early large-scale study found that people who did not attend church were four times more likely to kill themselves than were frequent church-goers (Comstock and Partridge, 1972).  Stack (1983) found rates of church attendance predicted suicide rates more effectively than any other evaluated factor, including unemployment.  He proposed several ways in which religion might help prevent suicide, including enhancing self-esteem through a belief that one is loved by God and improving moral accountability, which reduces the appeal of potentially self-destructive behavior.
  • Many psychiatric inpatients indicate that spiritual/religious beliefs and practices help them to cope. Lindgren and Coursey (1995) reported 83% of psychiatric patients felt that spiritual belief had a positive impact on their illness through the comfort it provided and the feelings of being cared for and not being alone it engendered.

Potential Harmful Effects – Psychiatry still needs more research and clearer hypotheses in differentiating between the supportive use of religion/spirituality in finding hope, meaning, and a sense of being valued and loved versus harmful beliefs that may manipulate or condemn.”

 

Read my article “Faith can help, & harm, a family’s mental health,” for potential harmful effects on families. –Margaret

  • Alcoholics often report negative experiences with religion and hold concepts of God that are punitive, rather than loving and forgiving(Gorsuch, 1993).
  • Bowman (1989).  In assessing multiple personality disorder, children in rigid religious families, whose harsh parenting practices border on abuse, harbor negative images of God.  Josephson (1993),Individual psychopathology is linked with families whose enmeshment, rigidity and emotional harshness were supported by enlisting spiritual precepts.
  • Sheehan and Kroll (1990).  Of 52 seriously mentally ill hospitalized patients diagnosed with major depression, schizophrenia, manic episode, personality disorder and anxiety disorder, almost one-fourth of them believed their sinful thoughts or acts may have contributed to the development of their illness.  Without the psychiatrist inquiring about potential religious concerns, these beliefs would remain unaddressed, potentially hindering treatment until discovered and resolved.  Collaboration with hospital chaplains or clergy may help in some of these instances of spiritual problems or distress.

Conclusion

Religious/spiritual commitment may enhance recovery from depression, serious mental or physical illness, and substance abuse; help curtail suicide; and reduce health risks.  More longitudinal research with better multidimensional measures will help further clarify the roles of these factors and whether they are beneficial or harmful.

–Margaret

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Help your child or teen ‘recover’ from a disorder or addiction

Help your child or teen ‘recover’ from a disorder or addiction
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What recovery looks like – A person with a mental or emotional disorder who is in “recovery” lives a normal life and aren’t affected by their disorder.  They look and act normal.  At the least, they have stable relationships, a steady job, a place to live, a regular diet, cleanliness, and regular mental health check-ins.  Recovery is maintained when the person pays attention to themselves to notice if the symptoms are starting, and then takes action to stop the symptoms.

Recovery is like the alcoholic who stops drinking–they still have an addiction, but they stop using.

What your child will need to sustain recovery as an adult:

INSIGHT  +  STABILITY  +  RESILIENCE

INSIGHT– self awareness

Insight allows a child to recognize they have a problem, and choose to act to avoid the problem.  If insight is not possible, they need a toolbox of options that help them to respond appropriately, instead of reacting to chaotic messages in their brain. Knowing and admitting they have a problem, or knowing techniques for avoiding problems, are very powerful skills they need as adults.

STABILITY – fewer falls or softer falls

Your child is like a boat that’s easier to tip over than most other boats; any little wave will capsize them, and everyday life is full of waves, big and small.  Your job is to notice when the troubled child is starting to capsize and show them how to right the boat, or if that doesn’t work, how to use the lifesaver.  Eventually, your child will learn how to sense when trouble is coming on, avoid the thing that causes problems, and ask others for help.  Sense it.  Avoid it.  Ask for Help.

RESILIENCE – bounce back when they fall

Troubled children have a much harder time bouncing back from problems.  They have extreme responses to simple disappointments like breaking a toy, or poor grades, or something as serious as the parents’ divorce.  Some even fall apart in joyous times because the emotional energy is too much!  You must be acutely aware of this–they will not get back on track by themselves.  Don’t worry that helping them will spoil them or “enable” them.  Eventually they will learn from you how you do it.

“…We are all born with an innate capacity for resilience, by which we are able to develop social competence, problem-solving skills, a critical consciousness, autonomy, and a sense of purpose.”

“Several research studies followed individuals over the course of a lifespan and consistently documented that between half and two-thirds of children growing up in families with mentally ill, alcoholic, abusive, or criminally involved parents, or in poverty-stricken or war-torn communities, do overcome the odds and turn a life trajectory of risk into one that manifests “resilience,” the term used to describe a set of qualities that foster a process of successful adaptation and transformation despite risk and adversity…”   http://www.athealth.com

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Filed under bipolar disorder, borderline personality disorder, depression, mental illness, parenting, schizoaffective disorder, schizophrenia, teenagers, teens

Mental illness more deadly than cancer for teens, young adults

Mental illness more deadly than cancer for teens, young adults
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Why isn’t everyone more upset?  A disease is killing our children and it’s worse than cancer and leukemia.  Why is pychiatric research 30-40 years behind cancer, as well as the development of pharmaceuticals and other treatment modalities?

We don’t get casseroles when our child is hospitalized for a mental health crisis

Out of curiosity, I did some research on child mortality rates from various causes, because I wanted to know how death from mental illnesses compared with other fatal illnesses of childhood and adolescence. The results were astonishing, unexpected, and disturbing.

Childhood Illness Age Range Annual Deaths per 100,000 Children
Cancers, leukemia: 5-14 yrs 2.6
Cancers, leukemia: 15-19 yrs 3.6
Childhood diabetes: Avg. 15 yrs 2.2
Anorexia: 15 – 24 years 6
Suicide ** 10 – 14 years 1.6
Suicide ** 15 – 19 years 9.5
Suicide ** 20 – 24 years 13.6

(The chart columns are in the order listed in the box, somehow I couldn’t get the right grays!)

* The starting point for the data on the medical illnesses was the website for the Center for Disease Control and Prevention www.cdcp.gov  in Atlanta; the starting point for the mental illnesses was the website for the National Institute for Mental Health, www.nimh.gov.

** The suicide data was from those with depression, bipolar disorder, schizophrenia, and psychotic disorders-unspecified.  (Suicide from other mental health causes, such as borderline personality disorder and co-morbid substance abuse, is also prevalent but I could not find data for young adults.)

This screams out for a changes in attitude, policy, and investment in children’s mental health treatment!  I had no idea that death rates from mental illness were 3 to 4 times higher than the feared cancers and leukemias.  It is imperative that young people with mental health issues receive aggressive and sensitive treatment as would be expected and demanded of medical doctors treating cancer.

The data was difficult to find, requiring searches in many different medical journals and numerous articles, as nothing like it was compiled in one place.  I chose to use the cancer, leukemia, and diabetes data because deaths from all other causes were insignificant by comparison.  The death rates for cancer and leukemia are averages for the different forms of each, and in the journals they were presented together.

I welcome additions or corrections of this data from any other sources, and encourage readers to investigate this for themselves.

 

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Filed under bipolar disorder, borderline personality disorder, depression, mental illness, mental illness, parenting, psychiatry, schizoaffective disorder, schizophrenia, suicide, teenagers