Category Archives: depression

Marijuana is uniquely dangerous for troubled teens

Marijuana is uniquely dangerous for troubled teens
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Marijuana’s effect on adolescents is much more serious than many realize, especially those with behavioral disorders.  This is no exaggeration; marijuana can lead to psychosis and long-term cognitive impairment for your troubled child.  Numerous recent research studies show that marijuana has a more damaging effect on the young brain than is generally understood. The THC in marijuana is psychoactive, which means it can affect your child’s unbalanced brain chemistry more than the general population. Serious depression, anxiety, paranoia, and psychosis can be triggered in children with latent psychiatric vulnerabilities. (additional marijuana research going back to 2004 are at the end of this post).

Just because marijuana is plant-based does not mean it is safe.  It has dangerous side-effects like any other psychoactive drug.

Marijuana legalization has deeply concerned pediatric psychiatrists and other providers specializing in child, adolescent, and young adult mental health treatment.  Up until the their early 20’s, young people’s brains undergo radical changes as part of normal development.  Neurons are “pruned” to reduce their number (yes indeed, one can have too much gray matter to function as an adult). Pruning occurs rapidly in teenagers–think about it, in addition to puberty, a lot of nonsensical teenage behavior can be explained by this.  The THC in marijuana, the part responsible for the high, interferes with the normal pruning process.

When marijuana is ‘medicinal,’ a doctor determines a safe dose.  And when it is ‘recreational,’ there is no such limit… teen users don’t realize there should be.

Let’s talk about “dose.”  Above a certain dose, which is different for each person, THC side effects can be intolerable to lethal (if it leads to unconsciousness or triggers suicidal thoughts).

“THC is known to relieve anxiety in smaller doses and increase it in larger; this is due to its bi-phasic effects, meaning it can have two opposite effects in high doses. Furthermore, some people are genetically predisposed to experience anxiety with cannabis as a result of brain chemistry.” —–What are the Side-Effects of High THC Cannabis. Bailey Rahn, 2016

Now let’s talk about long-term.  Our troubled children are already slipping behind their peers in important ways, which can include school; emotional maturity (certainly); and physical health (such as gut and digestive problems).   Marijuana will add to your teen’s problems by causing lethargy, impaired memory, and cognitive delays.

We can’t pretend or assume marijuana is safe anymore, regardless of its legality or medicinal uses.

I found this research result extraordinarily sad:

“Increasing levels of cannabis use at ages 14-21 resulted in lower levels of degree attainment by age 25, lower income at age 25, higher levels of welfare dependence, higher unemployment, lower levels of relationship satisfaction, and lower levels of life satisfaction.”
–Cannabis use and later life outcomes.  Fergusson DM, Boden JM, Addiction;  Pp: 969-76;  Vol: 103(6), June 2008

I worked with adolescents in residential care and in the juvenile justice system who regularly used marijuana when they could.  A young man on my caseload grew noticeably depressed after he started smoking regularly, and his anxiety, irritability, and paranoia increased.  He said that smoking helped him feel better, but he couldn’t observe what I and other social workers observed over time. Smoking marijuana, ironically, was temporarily relieving him of its own side-effects.

A clarification about the two substances in marijuana – The plant Cannabis sativa has two chemicals of interest:

  1. Cannabidiol (CBD) – the molecule is considered safe for a variety of treatments, such as relief of pain and nausea, and it is approved by the American Medical Association;
  2. Tetrahydrocannabinol (THC) – the molecule is responsible for the high, and is the one that can produce psychotic symptoms, paranoia, depression, anxiety, and memory loss.

Your child’s future is already at-risk, why worsen it with marijuana use?

Please share this information with other parents.   All children need the same warnings we give about alcohol and street drugs to include marijuana.  Whether you live in a jurisdiction where marijuana is legal or not, teens can and will find it.  It may not be possible to completely prevent your troubled child from using, but your caring persistence can reduce or end its use.

–Margaret

 

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12 Ways Dogs Reduce Depression & Anxiety

12 Ways Dogs Reduce Depression & Anxiety
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Most people know that dogs are good for one’s wellbeing, but these creatures literally improve one’s physical and mental health.

Dogs are medicine.

1. They lower our blood pressure

Research has proven time and time again that dogs significantly lower heart rates and blood pressure, before and after performing strenuous tasks. Blood pressure drops when one pets a dog. Petting dogs have also been known to ease pain and improve one’s immune system. It is like a dog’s mere presence is beneficial for pet owners.

2. They offer a soothing presence

Pets, particularly dogs, offer a soothing presence when one is performing tasks that take up a lot of mental energy. This goes a long way in helping speed up recovery of mental conditions.  It is well-known that some children will only respond to animals due to trauma or autism or intense anxiety.

3. They offer unconditional love and acceptance

Dogs are incapable of criticizing, judging or voicing their opinions. They snuggle up next to you even if you smell like poop.  Two reports describe the medical benefits of pets.  According to a 2013 white paper from the American Heart Association “…owning a pet, particularly a dog or a cat, is associated with decreased cardiovascular risk factors.”  The November 2015 Current Gerontology and Geriatrics Research published research showing “pet therapy programs have been shown to be effective in helping improve socialization abilities, lower blood pressure, and combat loneliness.”

There are other great therapy pets : “Benefits have been seen in owners of pets ranging from dogs, cats, birds, and fish to goats, chimps, and snakes.”  Be sure the right animal is matched to the owner.

4. Dogs alter our behavior

You or your child could come home annoyed at a million little problems that happened during the day, and maybe even taking anger out on someone. But imagine that before this happens, a smiling, tail-wagging dog walks up for attention.

Imagine, you or your child kneels and pets her, she licks your face and you smile. Just like that, your behavior is altered and chances that someone will become a casualty of frustration are now much better. People calm down in the presence of a dog, and don’t anger easily or use curse words.  Dogs make us slow our minds and our speech.

5. Dogs promote touch

There is no disputing the healing power of touch. An article published on Huffington Post cites that a 45-minute massage can reduce the levels of cortisol, a stress hormone, and build white blood cells which optimize one’s immune system. Hugging floods human bodies with oxytocin, a hormone that lowers heart rates, blood pressure and stress levels.

A study conducted at the University of Virginia showed that holding hands reduces stress-related activity in the hypothalamus region of the brain, which makes up part of the emotional center. It shouldn’t come as a surprise that stroking a dog can boost dopamine and serotonin levels while lowering heart rate and blood pressure.

6. Dogs distract us

It’s not a problem but a benefit! Dogs take us out of our heads and plunge us into another reality – one that involves affection, food, water… and scratching doggie butt for as long as we allow it. Distraction is sometimes the only thing you or your child needs when you have lost mental or emotional control. It is tough to ponder feeling awful when your dog is breathing in your face.

7. Dogs make us responsible

Owning a dog comes with responsibility and research has shown that responsibility promotes mental health. Psychologists assert that applying our skills to a job and taking ownership of a task helps build our self-esteem, which is why dogs are the most common therapy animals. When your child nurtures a happy healthy dog, it reinforces confidence and a sense of competence. This is especially important for troubled children who are often overtaken by their own thoughts and emotions.  Finally, pet care helps kids and teenagers learn independence and brings structure to their day.

Dogs pull a depressed or anxious child (or parent) out of their troubled head.

8. Dogs increase social interaction

Staying connected to other people or creatures is good for our depression. Starting a conversation is particularly scary for people suffering from depression. That isn’t true with dogs. They are natural social magnets that help pet owners connect with other people and maintain positive social contact.  Walk a dog, and people come up to meet the dog.

9. Dogs help one get into physical shape

Other than grooming, dogs need physical stimulation. This means taking walks and going out to a park to play. In the process of tossing a Frisbee or hiking with your pup, you get to exercise and enjoy nature simultaneously.

The energy boost consequently boosts your mood or blow off some steam.  Blood flow and oxygen to the brain is good for depression. When outside with a dog, your skin synthesizes vitamin D from the sun, which helps fight symptoms of depression.

10. Dogs are great listeners

The most effective way to release stress is to talk about it with someone. But what if you don’t have the courage to approach a friend? What if the idea of talking about your innermost worries makes you anxious?  Pet owners, particularly those who own a dog, will share their wishes and thoughts with a caring partner, with the guarantee that they won’t be disclosed to someone else. Even better, you can talk about your worries knowing that you won’t be judged

11. Dogs provide sensory stress relief

Movement and touch are some of the most effective ways to manage stress. Dogs offer the need for touch such as in grooming, petting and exercising them. Such tasks also help with sensory stress relief, which is particularly important for people suffering from depression.

12. Dogs help you find meaning and joy in life

Taking care of a dog can help lift morale and increase a sense of self-worth, optimism, and fulfillment.  If you’ve adopted a shelter dog, it’s also fulfilling to know you (and your child) provided a home to a dog that may have otherwise been euthanized.

Take care of your dog and your dog will take care of you.

Conclusion

The physical and mental health benefits of owning a dog for children, teenagers, and even the elderly are proven by research.

Note: Owning a dog is not a miracle cure for a family and child coping with anxiety and depression. Dogs are for those who appreciate and love domestic animals, and those who invest money and time to keep their dog healthy and happy.

By Andy McNaby

Founded by animal lovers, we provide honest reviews of pet products. We review products hands-on and we test products side-by-side, so you know you’re getting good honest reviews.

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Use the “S” word: talk with your child about suicide

Use the “S” word: talk with your child about suicide
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Don’t be silent on the subject of suicide, even if there’s no evidence your child has considered it.  Bring it in the open, especially if you have a hunch something is wrong.  This article addresses:

  1. Why you should talk about suicide with your child
  2. How to respond if there’s been a threat
  3. How to respond if there’s been an attempt

Parents talk about many uncomfortable subjects with their child;
and suicide must be one of them.

Suicide is one of many sensitive subjects.  Like other frightening subjects (sexual abuse and “stranger danger”), your child should feel safe talking with you about them.  It can be very difficult for a child to bring these up to parents.

Won’t this give my child ideas and encourage suicidal thoughts?

No.  Children usually know what suicide is and will have wondered about it—even young children. Ask what your child thinks. Children as young as 7 and 8 have asked about suicide or threatened it.  Children as young as 10 and 11 have attempted or completed suicide.  The ages of highest suicide risk are between 10 to 24.

Talk with your child. Don’t leave him or her alone with thoughts or questions about suicide.

An 11-year-old boy died of suicide a couple of weeks before this article was written. There had been no prior signs.  He killed himself after receiving a prank text saying his girlfriend had committed suicide. He told no one beforehand..

Why might my child consider suicide?

Mental health professionals assess risk by using the Biopsychosocial Model.  The more negatives in the biological, social, and psychological aspects of one’s life, the higher the risk of suicide or other mental health problems.

This diagram can help assess your child’s risk.

From Pinterest and the blog, Social Workers Scrapbook

What things in this diagram can you control and change at home?
What mental and physical health treatment do the child and other family members need (especially you)?
For things you cannot change, have family team meetings, work together to get through tough times safely.

What can trigger thoughts of suicide?  Two examples:

Oregon: Survey results provided these reasons behind an exceptionally high suicide rate among 10-24 year olds, 180 individuals in one year (“Suicide circumstances by life stage, 2013-2014”).

  • 62% – Current depressed mood
  • 53% – Relationship problems
  • 47% – Current mental health problems
  • 43% – Current/past mental health treatment
  • 42% – History of suicidal thoughts/plans
  • 31% – Recent/imminent crisis
  • 22% – Family relationship problems
  • 21% – Non-alcohol substance abuse problems
  • 8% – School problem

New York State: Life situations of children completing suicide, 88 individuals; (“Suicide Prevention, Children Ages 10 to 19 Years”, 2016)

  • Feeling hopeless and worthless (often because of bullying at school, home, or online)
  • Previous suicide attempt(s)
  • Physical illness
  • Feeling detached and isolated from friends, peers, and family
  • Family history of suicide, mental illness, or depression
  • Family violence, including physical or sexual abuse
  • Access to a weapon in the home
  • Knowing someone with suicidal behavior or who committed suicide, such as a family member, friend, or celebrity
  • Coping with homosexuality in an unsupported family, community, or hostile school environmental
  • Incarceration (time in juvenile detention or youth prison)

What if my child has threatened suicide?

A threat opens a door for a discussion.  A good approach is to interview your child about their feelings, plans, needs, and reasons.  Listen earnestly without input.*  You might be surprised to find their problem is solvable, but their depressed mood paints it as hopeless.  Listening helps them get clarity and feel heard and respected.  Once you understand their problems, you assist them in identifying options and provide emotional support.

* I have a friend who worked for a suicide hotline, and he said the job wasn’t difficult at all.  He said, “All I did was listen and show understanding of their feelings and just let them talk. “

After a frustrating discussion about my teenage daughter’s suicide threats, I gave up and said “No.  I’m telling you not to commit suicide.”  She was incredulous; “You can’t tell me what to do!  You can’t stop me!”  I responded, “Don’t commit suicide. You’re important to us.  You have important things to do in life.”  She made a few attempts in the following years (my hunch is that they were intended to fail), but she always reached out to her family afterwards for support.  Did my words make a difference?

What if a threat is just for attention?

It’s hard to tell. It could be real in some situations, but manipulative in others.  Some children use threats to prevent parents from asserting rules.  Angry children, especially teens, use threats to blame and hurt parents emotionally.  If you think a threat is not genuine, open up the suicide discussion.  “Talk to me about this”, “It seems like an extreme response; is there a better one?” “What needs to change?”  “How can I help?”  Focusing on the threat will either expose the ruse or draw out important information for addressing an underlying problem.

What else can I do if my child threatens suicide?

  1. Observe and investigate.
  • Do they have access to unsafe objects or substances?  You can legally search their room.
  • Do they frequent unsafe places or spend time with people who encourage drug use?
  • Do they have extreme mood swings (up or down), or a chronic dark mood?
  • Do they take dangerous risks and seek dangerous activities?
  • Are there any other danger signs?
  1. Build a network of eyes–choose people who will observe your child and keep you advised of risk, e.g. a mature sibling, a teacher, your child’s friend or the friend’s parents, your child’s boyfriend or girlfriend, a relative, or a trusted person who knows your child.
  1. Make changes you have control over, and solidly commit to these changes. Bring the whole family along on the plan.  FOLLOW THROUGH.
  • In family life – reduce chaos, fighting, blaming, or bullying; ensure everyone gets healthy sleep; express love and appreciation; neglect no one including yourself; create 2 – 3  house rules that are easy to enforce and everyone follows, even you.
  • In social and online life – learn as much as you can about the nature of your child’s relationships, whether romantic or social.  Suggest ideas if they stress your child. Can they remove themselves from a toxic relationship? or cope effectively with anxiety? Can you help them address bullying at school or online?
  • Biological health – Sleep, Exercise, Diet.  Limit screen time at night because blue light inhibits sleep.  Pay attention to digestive health, which affects mental health. These are some natural approaches.
  • Psychological health – Ask a school counselor about your child.  Seek a working diagnosis and mental health treatment. Then help your child find outlets for personal self-expression:  journaling, music, art, poetry, or a website such as this one, where teens help teens.  Mind Your Mind is an excellent example.

What if my child already attempted suicide?

He or she is still very fragile, even if in treatment!  They have taken the action, they’ve been there, and have the option for taking it again—a high percentage try againSuicide attempts are long-term emergencies. You need to be on alert in the following days, weeks, months, and possibly years.  In addition to intensive mental and physical health treatment, ensure your child gets regular deep sleep, exercise, and a good diet.  Ask them if they’ve had suicidal thoughts if you sense something is wrong.

Pay attention to events that trigger suicide (see the lists above).

Check-in with your child when something traumatic happens or might happen, especially if someone he or she knows attempted or committed suicide, or a suicide was in a TV drama or covered in the news.  Triggers are an emergency, act immediately.

You have the power to prevent a child’s suicide.
Be strong. You can do this. 

Take care of yourself.

–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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Life with a schizoaffective teen

Life with a schizoaffective teen
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I have first-hand experience raising a child with schizoaffective disorder.  Up until my child’s onset of the disorder in the ‘tweens’, I never thought I had much patience or backbone.   But one’s character strengthens with trials, and I learned I was patient and stronger inside than I thought.  Parenting my child entirely changed my life’s direction.

Farther down this post are practical tips and advice for raising your child.

My Story:  Schizoaffective teens have both schizophrenic symptoms (thoughts disconnected from reality) and affective symptoms (unstable emotions and moods).  What an unfair combination of experiences to sabotage one’s brain.   My child had to persevere through intense feelings, excruciating anxiety, and thoughts that rarely touched on facts.  How could anyone maintain any semblance of normalcy during this?   The mental effort of holding oneself together was exhausting.

My child was often exasperated with me, as other teens are with their parents:  “Mom, you don’t understand me, it’s like the TV’s on, the radio’s on, the stereo’s on, you’re talking to me, and I’m trying to read a book, and I can’t not think about every single thing.”  Right, I couldn’t relate.  I could not imagine processing 10,000 inputs at once without going crazy.

Hallucinations feel normal when you’re in them

My child had a slow early onset of hallucinatory experiences beginning about 11 or 12, and was able to hide it until 14.  She considered the hallucinations and voices normal, and became accustomed to them.  Eventually, she noticed that others didn’t see or hear the same things:  the rhinoceros walking by; the sky turning green; words writing themselves on a blackboard.  To my child, here was proof of being special, magical, a traveler on the metaphysical plane.  Because there was proof, she felt superior to others and that she had special powers.

I have never had hallucinations, but imagine they are like dreaming wide awake.  My child’s audio hallucinations included something out of Monty Python:  two loudly arguing British ladies, with thick Cockney accents, relentlessly criticizing each other’s cooking and husbands.  She complained it was impossible to hear what the teacher said in class.  (Even today, during summers when she is happy, the stand-up comic voice visits and tells jokes throughout the day.  Our family witnessed many outbursts of laughter and giggling for no apparent reason, then started laughing contagiously.

My child’s visual hallucinations took fascinating forms:  stairs looked like a cascading waterfall; a living room chair continually rotated in space instead of standing still; moving objects left trails in space, like a series of images seen with a strobe light.

She awoke one morning with stories of her life as a queen for 1000 years, and talked about it in extraordinary detail.

My child is the bipolar type of schizoaffective person.  While depressive types don’t have the highs or excessive agitation,  they still suffer with anxiety and paranoia.  When she was in a down cycle, she darkened her room and slept in a pile of bed-clothes on the floor.  She avoided things with negative symbolic meaning, such as certain people, certain streets, or certain names.   For some reason, sunflowers and Christmas were upsetting.  During depressive phases, she talked about suicide, or “caught” other disorders such as anorexia and PTSD.  I was often accused of abuse and endured many hurtful words.

Haunted by anxiety and paranoia

Anxiety and panic are torturous, and I wished I could have spared her from the pain.  She would obsess on a past emotional hurt and become horribly upset for hours, days, weeks at a time. (In my stress and ignorance back then, I yelled at my child unaware of how hard this impacted emotional memory.)  I had to apologize a zillion times.

My child continues to obsess on ancient hurts, now well into adulthood.  Any traumatizing experience can become a theme in the life story of a schizoaffective person.   They will refer to it and make connections to it for the rest of their lives.   Big issues with my child are about money (having money, people stealing money, having no control over money).   It’s common for her to interpret any event as the turning point when everything started to go downhill, “That’s when you took all my money, “That’s when you ruined my life.”

It may not be preventable.  It’s the very nature of schizophrenia spectrum disorders to find something to be paranoid about.  The point is for a parent to learn to avoid triggering the traumatic memories, and avoid reasoning or explaining what really happened.  Our children cannot reason once upset.  I had to learn to “de-escalate” my child, don a quiet and patient demeanor, affirm feelings, show empathy, and change the subject (“redirect”) etc.

Stalkers of famous people often have schizoaffective disorder

She did some reading and told me that people with schizoaffective disorder often believe they are connected to a celebrity’s life as lovers or confidantes, and some will stalk that person.  John Hinkley is a famous case.  He believed he was the boyfriend of actress Jodie Foster.  In her film, “Taxi Driver,” her would-be boyfriend attempted to assassinate the president to impress her.  Hinckley did the same, and attempted to assassinate then-President Ronald Reagan.  In prison, Hinkley was diagnosed with schizoaffective disorder.  The Beatles musician, John Lennon, was killed by Mark David Chapman, who believed he was the rock star and John Lennon was impersonating him–Chapman is another person with schizoaffective disorder.  I was amused that she realized, only then, that her ever-present (invisible) boyfriend was a famous rock star.

Partial complex seizures can simulate symptoms of schizoaffective disorder

Partial complex seizures of the left temporal lobe (temporal lobe epilepsy) cause, enhance, or simulate symptoms of schizoaffective disorder.  If your child has not had an EEG, request one.  If there is seizure activity, it can be treated by anticonvulsants such as Tegretol (carbamazepine).  This helped to reduce many of my child’s symptoms, such as intermittent bouts of terror, seeing auras around people, and color changes in the sky.  (See an abbreviated article with an explanation at the end of this post.)

Lessons I learned

  • Don’t challenge your child’s beliefs about their experiences, even if you think they are strange, focus instead on keeping your child functional: taking meds, attending school, engaging in safe activities, and managing personal care.  You will be better able to correct/redirect their thinking once they feel comfortable speaking openly with you.
  • Believe and act on any references to suicide or destructive ideas—this may be manipulation, but don’t take the chance.   If you believe your child is being manipulative or overly dramatic, ask them respectfully to stop.  Yes, just ask.
  • Allow your child to talk comfortably about their hallucinatory experiences.  You want to know what they are witnessing or monitoring in their head.  You want to know if a voice is verbally abusing your child, or telling them to hurt themselves or others.
  • “Inoculate” your child from cruel voices or messages–teach them to deny the power of the voice or not take it seriously.  Example:  “I know you can’t stop [this voice] from pestering you, but it’s OK to resist [him] or ignore [him].  [He] has no power over you.”  She was very upset once because her rock star boyfriend/ghost yelled at her.  I told her to tell him, “Stop it and leave me alone! Don’t talk to me that way!”  She did (somehow), and it worked!  The rock star guy stopped talking to her for a couple of days (as if he was sulking), and returned and was nice to her again.

Things you can do

  • Low stress is a priority. Create a low-key environment in the home, limit sensory input, use quiet or soft voices as much as possible.
  • Allow your child to avoid over-stimulation–crowds or energized spaces with too many things happening (parties, malls, sports events or activities, slumber parties, or whatever they say it is).
  • Don’t argue with them if something they say doesn’t make sense to you.  Listen attentively and avoid offering your opinions.  Let me repeat, don’t reason with someone who is inherently irrational.  Ensure they are safe, comfortable, and appropriate, and spend quality time listening like you would any other child.
  • Help them avoid anxiety-causing things or places.  Go out of your way.  Make a point of driving down a different road, or bringing them home from an event early, even if it’s inconvenient.  This is respectful and humane because they are  agonizing about something that you don’t experience.  You need their trust in you to protect them from their own mind.
  • Ask your child what they need to calm down or settle.  If they want to be in a dark room with the windows covered with foil, fine.  If they want to listen to loud ghastly music through headphones, fine.  Just watch.  It will be obvious if it settles them, or helps them focus and relax.
  • Allow your child to be weird at home as long as they adhere to basic rules.  “I respect your freedom to be who you want to be, but you must take showers and wear clean clothes.  Hygiene is the family policy.  This rule won’t change, but I am happy to help you with this if you want.”  No reasoning or justification, just a simple statement of the rules everyone follows.

You can ask for, and expect, respectful behavior

It is possible to ask your schizoaffective teen to stop disrespectful or harmful, inappropriate behavior, and it is possible to set a boundary if done in a respectful straightforward manner without justifying yourself.

Example of something I said to my daughter during a particularly dark period:  “I’m leaving the house and I’ll be gone about 2 hours.  Do not try to commit suicide, stay right here in your room and be calm.  I’ll bring you a snack when I get home.”  Note that this gave her a reason to wait until I came home.

Outcomes are poor with schizoaffective people, but statistics say they have a better long-term prognosis than those experiencing schizophrenia (see “Outlook for schizoaffective disorder and schizophrenia”).  Perhaps it’s because their emotional awareness gives them the ability to form friendships and relationships, and talk about feelings (unlike those suffering with ‘pure’ schizophrenia).  See article at the end of this post, “Social Interaction Increases Survival by 50%.”

You are in this for the long haul.  You will experience a roller coaster ride of emotions.  Pace yourself as if in a marathon.  There may be multiple crises  and hospitalizations, but these may space farther apart over time with treatment and family support, and you’ll have respite.  Your child will settle into stable, repeated patterns unique to them, and you’ll learn which triggers to avoid, and to ignore what isn’t important.  You’ll also learn how to bring them back into positive states of mind, and set up a healthy environment where they choose to stay.  Have hope.  I lived this, and can attest to it.

 

–Margaret

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Complex Partial Seizures Present Diagnostic Challenge  (summary)
Richard Restak, M.D. | Psychiatric Times, September 1, 1995

Temporal lobe epilepsy (TLE), is now more commonly called complex partial seizure disorder. It may involve gross disorders of thought and emotion, and patients with temporal lobe epilepsy frequently come to the attention of psychiatrists.

A Dr. Jackson observed in the late 1800’s that seizures originating in the medial temporal lobe often result in a “dreamy state” involving vivid memory-like hallucinations sometimes accompanied by déjà vu or jamais vu (interpreting frequently encountered people, places or events as unfamiliar). Jackson wrote of “highly elaborated mental states, sometimes called intellectual aura,” involving “dreams mixing up with present thoughts,” a “double consciousness” and a “feeling of being somewhere else.” While the “dreamy state” can occur in isolation, it is often accompanied by fear and a peculiar form of abdominal discomfort associated with loss of contact with surroundings, and automatisms involving the mouth and GI tract (licking, lip-smacking, grunting and other sounds).

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Social Interaction Increases Survival by 50%

Psychiatric Times. July 30, 2010

Theoretical models have suggested that social relationships influence health through stress reduction and by more direct protective effects that promote healthy behavior. A recent study confirms this concept.  Findings from a meta-analysis published in PLoS Medicine indicate that social interaction is a key to living longer. Julianne Holt-Lunstadt, PhD of Brigham Young University and colleagues analyzed data from 148 published studies (1979 through 2006) that comprised more than 300,000 individuals who had been followed for an average of 7.5 years. Not all the interactions in the reports were positive, yet the researchers found that the benefits of social contact are comparable to quitting smoking, and exceed those of losing weight or increasing physical activity.

Results of studies that showed increased rates of mortality in infants in custodial care who lacked human contact were the impetus for changes in social and medical practice and policy. Once the changes were in place, there was a significant decrease in mortality rates. Holt-Lundstadt and colleagues conclude that similar benefits would be seen in the health outcomes of adults: “Social relationship-based interventions represent a major opportunity to enhance not only the quality of life but also of survival.”

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