Category Archives: mental illness

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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What’s in your troubled child’s future?

What’s in your troubled child’s future?
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Are you scared for your child’s future? Is he or she is falling behind in everything that is important for their future?

Will they have a future worth living? Will they manage as adults? Will they fail?

This chart is a spectrum of long-term outcomes for people with mental health disorders.  Your child will fall somewhere in one of the five columns.  No matter how ill your child is, if a network of family and friends can sustain support over the long-term, you’ll likely keep them from the worst-case scenario in the far right column.  There is research evidence for this.

However you define it, your child’s wellbeing is your main mission as a parent.

Your child may be struggling in critical areas of development, and problems are adding up:

  • Friend problems:  they have inappropriate friends, or no friends, or they mistreat friends (and siblings).
  • Behavior problems:  they do or say disturbing things (swearing, hurting, breaking, manipulating, sinking in depression, attempting suicide…). Everyone is stressed.
  • School problems:  disruptive behavior; poor grades (or a sudden drop in good grades); bullying or being bullied.
  • Health problems:  physical health problems become mental health problems, and vice versa:
    • trouble with sleep
    • digestive system and gut problems
    • poor diet and lack of exercise
    • epilepsy or neurological disorders
    • hormones during puberty
    • substance abuse.

We designate legal adulthood stages at the ages 18 and 21.  That’s young.  Many normal healthy young people at this age are immature and irresponsible, but your son or daughter may lag well behind them.  Your child may need support and rescuing well into the 20’s or early 30’s–this is not unusual.

You’ll survive the marathon of tough years by pacing yourself, finding support for yourself, and setting a few boundaries.

There is reason for hope.  Your child may take many horrible directions in their teens and 20’s, and you may feel hopeless or helpless as you witness their life nosedive.  If you can hang on and marshal support for yourself, your child will find a circuitous path to recovery.  It will have sharp turns and back steps and falls, but they’ll find it… and enter stable adulthood.

Some parents and families have seen the worst.  They’ve endured violence due to their child’s addiction; sat in court when their son or daughter was convicted of a crime; or they waited in the Emergency Room when their son or daughter was admitted for psychiatric care.  They also lived to see their child achieve the sanity to finish their education, support themselves, develop good relationships, and get that future you always wanted for them.

How two parents handled a worst case scenario (yours may never get this bad):

These are true stories of mothers who stuck by their very ill adult children and provided what little they could to bring a bit of wellbeing.  These mothers found some peace by simply doing what they could.

One had a grown son with schizophrenia and a heroin addiction who lived in squalor in supported housing.  He spent all of his disability assistance money on heroin and nothing else.  Her efforts to help him met with verbal abuse and threats of violence, and she feared for her safety.  What could she do, witness his slow suicide by starvation or overdose?  She arranged to visit him once a week in the parking lot, and brought 2 sacks of groceries in the trunk of her car.  He was to come out and get the groceries while she stood at a safe distance.  This worked.  He was still verbally abusive when he got the groceries, but he got food and she stayed safe.

One had a son addicted to methamphetamine who was lost to the streets. One day, she discovered a nest of old clothes and rags in an overgrown area behind her garage, and instinctively knew it was from her son.  “Good,” she thought, “He’s alive; I can keep him safe.”  She rarely saw him come and go, but she replaced the rags with clean blankets and a sleeping bag, and put out food for him, and provided a tarp for cover.  She couldn’t free her son from addiction, but she could keep him safe from the streets and its desperate people, and fed and sheltered in a way he accepted.

–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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Outlook for schizoaffective disorder and schizophrenia

Outlook for schizoaffective disorder and schizophrenia
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How Schizoaffective Disorder compares to other disorders

There is little information about schizoaffective disorder in children, which usually starts around puberty.  As a parent, you know how seriously it affects your child, but how does it compare to depression and bipolar (manic and depressive states) and schizophrenia?  What is the course of schizoaffective disorder, and how can you help your child’s future?

Schizoaffective disorder is not as serious as schizophrenia,
but more serious than bipolar/depression.

Research conducted in Britain* studied young people who received typical treatment for schizoaffective disorder, schizophrenia, and bipolar/depression who were between the ages of 17 and 30 (average age was 22).  Over a 10 year period, those with schizoaffective disorder improved slightly, better than those with schizophrenia.

Outlook for schizoaffective disorderBehavioral functioning over time for schizoaffective disorder, schizophrenia and affective disorders (depression, bipolar) at four consecutive follow-ups.  (This scale goes from 2 (good) to 6 (poor). A “1” would be the level of a person with no symptoms and who is considered normal.)
*M. Harrow, L. Grossman, Herbener, E. Davies; The British Journal of PsychiatryNov 2000, 177 (5) 421-426

Behavioral functioning is measured by how well a person does in five areas:Russian brain diagram

  1. Work and social functioning
  2. Adjustment to typical life situations
  3. Capacity for self-care
  4. Appearance of major symptoms
  5. Number of relapses and re-hospitalizations.

Your child will struggle with these, but there’s good news according to a recent landmark study:
Family support improves a patient’s outcome.

Life with a schizoaffective teen,” tells my story, and what steps I discovered which worked to improve my daughter’s functioning and behavior.  This article also provides insights into how children with schizoaffective disorder think.

A new treatment program was developed that altered some well-established practices.  A set of schizophrenia patients received the following support and were later compared with those who had the usual medication approach.

  1. Dosages of antipsychotic medication were kept as low as possible
  2. Help with work or school such as assistance in deciding which classes or opportunities are most appropriate, given a person’s symptoms;
  3. Education for family members to increase their understanding of the disorder;
    (“Efforts to engage and collaborate with family members are often successful during an acute psychotic episode, whether it is the first episode or a relapse, and are strongly recommended.
    Family Involvement Strongly Recommended by the American Psychiatric Association)
  4. One-on-one talk therapy in which the person with the diagnosis learns tools to build social relationships, reduce substance use and help manage the symptoms.”

Patients who went through this for of treatment made greater strides in recovery over the first two years of treatment than patients who got the usual drug-focused care.  More here.
New Approach Advised to Treat Schizophrenia, Benedict Carey, New York Times, Oct. 20, 2015

“..if you look at the people who did the best—those we caught earliest after their first break with reality—their improvement by the end was easily noticeable by friends and family.”

beautifulbrainThe longer psychotic symptoms stay in an extreme phase,” in which patients become afraid and deeply suspicious,” the more likely the person will be vulnerable to recurring psychosis, and the more difficulty they will have coming out of it and adjusting to normal life.

How to help your child

Be very realistic about what your child can handle in school.  They may be extremely intelligent–but maybe can’t handle too much homework; or class disruptions; or lack of empathy from the teacher.  A parent or school counselor should help your child find low-stress classes or activities, and consider limiting the number of classes per day.  They can only hold it together for so long!  I found it helped my schizoaffective child to take later classes, starting at 10 or 11 am.

Get the whole family on board to make his or her life easier.  Your child might be stressful and a source of irritation for everyone, but family members can help reduce this by taking on the chores your troubled child would ordinarily do; avoid pressuring them about something, or anything; and allow your child to say oddball things without confronting them about how irrational they are or arguing with them.

DIY talk therapy – Here are some ways to guide your child out of their troubled states.

Anxiety

  •  psychosisSchizoaffective kids may express anxiety in a tangled web of seemingly unrelated things, and spike them with paranoia about what they mean. Listen carefully, and conduct a gentle interview to explore what truly is bothering them.  It may be as simple as the room being too cold.
  • Give them plenty of time (if you can). A venting session is sometimes all they need.
  • Diplomatically redirect a negative monologue with a comment about something pleasant. This is where it’s useful to hand them a cat or call over a dog, offer tea or juice, or briefly check email.  The point is to break the spell.

Run-on obsessive thoughts

  • Voices and thoughts can be angry, mean, and relentless. Your child may not tell you this is happening, or may simply assume you already know what’s in their head.  Ask him or her if thoughts or voices are pestering them.  If so, show indignation at how wrong it is for them to mistreat your child, “that’s not right that this is happening to you; this is so unfair to you; you deserve better; I want to help if I can…”
  • Encourage your child to ignore the voices/thoughts and they may go away, or encourage them to tell the voices/thoughts to leave them alone. “I refuse to listen to you anymore!  Quit pestering me!  Obsessive thoughts and voices are just bullies.

Help your child stand up to thought/voice bullies the same as
as you would help any child dealing with a bully.  This works.

Life with a schizoaffective teen,” tells my story, and what I discovered that worked to improve my daughter’s functioning and behavior.  It also provides insight into how people with this disorder think.

Take care and have hope.  You can do this.

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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