The Facts About Mental Illness - The Mary Elise Millus Foundation

According to the National Institute of Mental Health and the World Health Organization, research shows that 50% of all lifetime cases of mental illness before the age 14.
About 1/4 of children and teens experience some type of mental disorder in any given year, 1/3 at some time in their lives. The most common kind of mental disorders are anxiety disorders, like overanxious disorder of childhood or separation anxiety disorder. Other common types of mental illnesses in childhood include behavior disorders like attention deficit hyperactivity disorder.
Depression occurs at a rate of about 2% during childhood and from 4%-7% during adolescence, affecting up to about 20% of adolescents by the time they reach adulthood.
The prevalence of adolescent depression is high, it is significantly underdiagnosed and undertreated. Because of the lack of mental health care professionals, family physicians are often responsible for detecting and treating childhood and adolescent depression, however, they are often not trained properly to do so.
As is the case with most mental-health disorders at any age, such disorders in children do not have one single definitive cause. Rather, people with these illnesses tend to have a number of biological, psychological, and environmental risk factors that contribute to their development. Biologically, mental illnesses tend to be associated with abnormal levels of neurotransmitters, like serotonin or dopamine in the brain, a decrease in the size of some areas of the brain, as well as increased activity in other areas of the brain. Girls are more likely to be diagnosed with mood disorders like depression.
Children and adolescents with a mentally ill parent are up to 4 times more likely to develop such an illness themselves. This must be acknowledged by the parents of a young child and accepted. Only then will you recognize the warnings signs and be in a position to help.

Social anxiety disorder is a persistent fear of embarrassment, ridicule, or humiliation in social settings. Typically, affected children avoid situations that might provoke social scrutiny (e.g., school). Affected children are terrified that they will humiliate themselves in front of their peers by giving the wrong answer, saying something inappropriate, becoming embarrassed, or even vomiting. In some cases, social anxiety disorder emerges after an unfortunate and embarrassing incident. In severe cases, children may refuse to talk on the telephone or even refuse to leave the house.
Nonsuicidal self-injurious behaviors can include superficial scratching, cutting, or burning the skin (using cigarettes or curling irons), as well as stabbing, hitting, and repeated rubbing the skin. In many adolescents, these behaviors do not indicate suicidality but instead are self-punishing actions that they may feel they deserve; these behaviors are used to gain the attention of parents and/or significant others, express anger, or identify with a peer group. However, these adolescents, especially those who have used multiple methods of self-harm, have an increased risk of suicide.
Suicides take the lives of 11% of children from 12-19 years old per year from 1999 to 2006, which amounts to 1,801 deaths per year during that period. Unaccounted for in this number is deaths by overdose or “accident” not categorized as suicide.
Because mood disorders such as depression substantially increase the risk of suicide, suicidal behavior is a matter of serious concern. The incidence of suicide attempts reaches a peak during the mid-adolescent years, and mortality from suicide, which increases steadily through the teens, is the third leading cause of death at that age.
There is good evidence that over 90 percent of children and adolescents who commit suicide have a mental disorder before their death. The most common disorders that predispose to suicide are some form of mood disorder, with or without alcoholism or other substance abuse problem, and/or certain forms of anxiety disorder.
Treatment options are few or many, depending how you look at them. Treatment of childhood and adolescent depression consists of psychotherapy, pharmacotherapy, or a combination of these. Stay involved in your child’s treatment. Moreover, provide your child’s psychiatrist with a HIPAA form authorizing you to speak with the physician concerning your child’s care and have access to all medical records, even when your child turns 18. Urge your child’s psychiatrist to work as a team with his/her psychotherapist to come up with the best treatment plan for your child.

There are other alternative treatment options as well:

Dialectical Behavior Therapy – (DBT) is a research-based, cognitive-behavioral treatment to help clients with the suicidal and self-harm behaviors often seen in Borderline Personality Disorder and has since been modified as a treatment for other complex and challenging mental disorders that involve emotional dysregulation, such as dual diagnoses, PTSD, eating disorders and severe mood disorders. Clients with these disorders often have great difficulty managing the emotional and relational crises of their lives, because they lack the needed behavioral coping skills. Using both acceptance and change strategies, DBT asks both patient and therapist to find a balance between accepting reality as it is, and maintaining a strong commitment to change. Such treatment is ideally offered in an environment that is warm and validating, while attempting to offer enough challenge and guidance to effect behavioral change and reduction of harmful behaviors. The goal is to help clients create “a life worth living.” Research has shown that DBT treatment is most effective when it includes 1. individual therapy, 2. a weekly skills training group and 3. help with skills application by phone with the individual therapist between sessions.

For more information about DBT please go to www.behavioraltech.com.

Cognitive Behavioral Therapy – (CBT) is a short-term, goal-oriented psychotherapy treatment that takes a hands-on, practical approach to problem-solving. Its goal is to change patterns of thinking or behavior that are behind people’s difficulties, and so change the way they feel. CBT works on the assumption that emotions, including depressed feelings, are influenced by thoughts and behaviors, and that it is possible to change negative emotions by changing the way young people think about, or act in response to, stressful situations. For example, an adolescent who becomes depressed after an experience of academic failure may have reacted by engaging in overly general self-critical thinking (“I am stupid”) and by giving up on studying in a helpless manner. By working with the adolescent to react to frustration with active coping (e.g., seeking help) and by more realistic thinking (“I did not do well on that test, but I could do better if I got some additional help”), CBT counters the depressive reaction and helps the adolescent to build skills to prevent future depression.

Ketamine – Depression frequently emerges during adolescence and is associated with severe outcomes. Current interventions do not lead to remission for many adolescents. Treatment-resistant depression (TRD) in adolescence is an ominous prognostic indicator for a lifetime of suffering and increased risk for suicide. As such, efforts have been directed toward novel interventions that could alter this perilous course. Theoretically, restoration of healthy development during this critical window would substantially improve outcomes over the lifespan. Ketamine has long been used for induction and maintenance of anesthesia in children and adults, and recently has been investigated for its rapid antidepressant effects. Randomized, double-blind, saline-controlled trials in adults with TRD have demonstrated that a single, subanesthetic infusion of intravenous (IV) ketamine can produce a rapid (within 2 hours) antidepressant response. Recent evidence suggests that serial doses of ketamine may be even more effective and may lead to more prolonged remission.

See: publichealth.yale.edu/news/archive/article.aspx?id=14682

Single Photon Emission Computed Tomography (SPECT) imaging – is not well accepted by the medical community as a whole. SPECT measures blood flow and activity patterns. It looks at how the brain works. It’s similar to positron emission tomography (PET) scans, which looks at glucose metabolism. When using SPECT imaging, physicians look for three things: 1. Areas of your brain that work well; 2. Areas of your brain that are low in activity, and 3. Areas of your brain that are high in activity.

See: http://neurocritic.blogspot.com/2012/08/the-dark-side-of-diagnosis-by-brain-scan.html

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The Facts about Mental Illness and Children

There are other alternative treatment options as well:

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