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Mental Illness Exacts Heavy Toll, Beginning in Youth
Researchers supported by the National Institute of
Mental Health (NIMH) have found that 1/2 of all lifetime cases of mental illness begin by age 14 and that despite effective treatments, there are long delays - sometimes
decades - between first onset of symptoms and when people seek and receive treatment.
The study also reveals that an untreated mental disorder
can lead to a more severe, more difficult to treat illness and to the development of co-occurring mental illnesses.
Related
anxiety disorders, including phobias, compulsions and panic, aren't included in these figures and further increase the prevalence of anxiety disorders.
July 2006
a personal note: I was experiencing severe chest pain in the solar plexus
area. It would last hours. It took almost three years for physicians to finally diagnose it as panic disorder. I underwent many unnecessary operations and tests that cost hundreds of thousands of dollars. I'd like to say this is unusual,
but it's truly more - the norm.
By Jeremy Laurance, Health Editor Tuesday, 4 September 2007
An international alliance of specialists in mental health is launching a campaign today
to shift the focus of the world's attention from disorders of the body to disorders of the mind.
Some 30% of the world's population suffer some form
of mental disorder each year, yet at least 2/3 receive inadequate or no treatment, even in countries with the best resources, such as the UK.
Mental illness outranks cancer and heart disease as a cause of chronic ill health – mainly due to the disabling nature of depression and alcohol or drug problems – yet it attracts a fraction of the resources of these more fashionable conditions.
In a series of articles published in The Lancet, experts from the World Health Organization,
the London School of Hygiene and the Institute of Psychiatry in the UK appeal to governments and medical organizations around
the world to increase funding for mental health and make it a central theme of their wider health strategy.
As much as 14% of the global disease burden is attributable to mental
illness according to estimates by WHO in 2005, yet the condition is marked by stigma and neglect. Almost a quarter (23%) of the global burden of disability is due to mental problems, compared with 21% for heart disease
and stroke and 11% for cancer.
Professor Martin Prince of the Institute of Psychiatry said even those high figures were
likely to be an underestimate because the impact of mental health on physical health went unrecognized.
The most obvious fatal impact of depression was when it led sufferers to take their own lives with 800,000 suicides each year around the world, 9 out of 10 of whom suffered a serious mental problem in the weeks leading up to their deaths.
But depression carried an increased risk of death for other reasons, such as by contributing to a less healthy lifestyle with more smoking and less exercise.
Stigma also played a part in denying mental patients treatment for physical illness. An Australian study found mental patients with
heart disease were less than half as likely to receive surgery for their condition and were 80%
more likely to die from it than unaffected patients.
"We have missed these links [between mental and physical
health]. Without them we fail to capture the full impact of mental illness,"
Professor Prince said.
Almost 1/3 of countries worldwide have no budget for
mental health and 1/5 of those that have spend less than 1% of their total health budget
on it, compared with 10% in the UK. Shekhar Saxena of WHO said inequities in provision were rampant.
"High income countries have up to 200 times more psychiatrists, psychiatric nurses and
psychologists. Low income countries are losing resources – in two years' time the situation will be even worse," he
said.
Too often, countries were training more psychiatrists and investing in expensive mental
hospitals and beds when the money would be better spent on psychiatric nurses and community care, he said.
Professor Vikram Patel of the London School of Hygiene said there was robust evidence
to show that scaling up services in countries where they were most sparse was cost-effective. Over 10 years the cost was estimated
at $2 (£1) a person in low income countries and $3-$4 in middle income countries.
Richard Horton, editor of The Lancet said there had been "a critical failure of leadership" by Western countries.
and you can help support me in my writing ventures by visiting my health and happiness column for the Dayton,
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I do appreciate you so much!
Got questions, concerns, suggestions or just want to say hello? Need someone
to vent to about your situation? Are you feeling very alone? Just send me an e-mail and I'll be here for you if you need someone.
I'm always available to chat or exchange ideas or to just listen!
In my own personal situation,
I had been experiencing debilitating painful attacks for over one year. Several doctors, specialists and hospital personnel
saw me in horrible pain, unable to control it at all, but they treated me as if I were faking it to get drugs from them. Finally
after years of unnecessary tests and operations, a specialist bluntly told me that I was experiencing panic attacks.
It was a woman. I was five months pregnant and taking about
3-5 percocets a day for pain. This specialist asked me for my vial of pills and when I handed them to her, she put them in
her pocket. She told me to go find a counselor who could help me control myself.
The stigma for mental health was still so strong that this
specialist was making me feel as if something were horribly wrong with me, that I was stupid for not understanding it was
panic attacks and that perhaps I had no reason to be experiencing them. She induced great feelings of shame and guilt within
me.
In reality I was living in a transitional housing program,
going through a horrendous custody fight for my eight year old son, pregnant, dealing with parental alienation tactics, and
had lost my best friend who had stolen my husband and had promised me to steal my son.
I had no family around me. Friends were afraid to intervene.
My ex-husband was a police officer. He quit his job to avoid paying child support. He had been abusive towards me and my children
throughout our eight year marriage. I had to send my two daughters from a previous marriage to their father in another state
because he was breaking me down - step by step - using hostile aggressive parenting techniques and parental alienation.
Mental illness held such a negative stigma that the doctor
made me feel as though I deserved everything that was happening to me.
Diagnosing Mental Illness by Kellen Von Houser
I
frequently a lot of misunderstanding in my practice about what a "mental illness" is. For instance, many clients are under
the impression that experiencing "mood swings" means they have Bipolar Disorder. Bipolar Disorder is much, much more serious
than simple "mood swings" and involves the administration of a very serious class of drugs - mood stabilizers or antipsychotics.
These drugs have very serious and sometimes permanent side effects.
Mood swings are a normal human experience and
not indicative of disease or illness. (See my article, "Mood Swings are Normal" for more information.) Likewise, many people
are unclear about what is required to be diagnosed with Major Depression.
So I decided to create a page on my blog
listing the diagnostic criteria for the major mental illnesses. Especially with the mood disorders it is important to note
the length of time the mood must persist in order to be consider a "mental illness" or "disorder".
Intent.com
is a premier wellness site and supportive social network where like-minded individuals can connect and support each others'
intentions. Founded by Deepak Chopra's daughter Mallika Chopra, Intent.com aims to be the most trusted and comprehensive wellness
destination featuring a supportive community of members, blogs from top wellness experts and curated online content relating
to Personal, Social, Global and Spiritual wellness.
Mental Health
& Medical Professionals Need To Re-examine Customer Service Skills By Kathleen Howe
It's a newly "recognized" population seeking mental health and medical services in today's world. The statistics say
it all when over 11.7% of the military are currently reacclimating themselves into everyday society with post traumatic stress
disorder, depression and other mental illnesses. Their families also affected need mental health support as well. Other types
of illnesses such as cancer patients, recovering victims of abuse, violent crimes and automobile accidents are all suffering
from mental illnesses as well and are suddenly finding themselves "admitting to their mental illnesses" despite the negative
stigma that mental illness has always entertained. Trusting in the belief that the medical and mental health workers are professional
and educated concerning mental illness - the vast number of patients in this dilemma are hoping they don't regret being so
candid concerning their diagnoses.
With so many people realizing the causes of their daily troubles to be centered
around their brain and how it is or isn't working correctly - isn't it time for the medical and mental health professions
to learn how to deal with these people in a professional, dignified manner? Isn't it time that their mental illness be recognized
as well as the symptoms that might escalate upon injury, loss, accidents, additional traumas and crises that happen to people
on a daily basis? The answer to both questions is clearly a resounding, "yes!" and the time is now for improvement.
Imagine this true story happening within your practice
or associated facilities. A woman who had dealt with abuse, domestic violence, severe trauma and crises her entire life beginning
in early childhood had finally escaped from the victimhood she had embraced for over forty years. Starting her life over after
relocating to a new city where she knew not a single soul, she was properly diagnosed with PTSD, depression and an eating
disorder. After establishing a treatment program of medication and counseling, she began her recovery. Spending an immense
amount of time in self study of mental illness, eating and sleep disorders and lifestyle factors that affect mental and physical
well being; she began to feel comfortable with admitting to others that she in fact experienced PTSD and depression.
Upon
a visit to her dentist office she visited with the office staff and had to overcome a phobia of dealing with financial matters
to speak about a balance which was overdue. She had been handling things so well until this moment when an unexpected repair
had to be made to her home and the money wasn't available for the dentist bill. In good spirits she carefully and slowly explained
the problems to the staff to ask for an extension. Being sure to speak slowly and clearly, being mindful of her breathing
techniques and monitoring her level of stress within her body; she admitted to having the PTSD and depression and reflected
the fact that on her medical chart within the office there were many medications that she was taking on the chart. She explained
that this was what they were for and that she was on a steady journey of personal growth and recovery. She spoke confidently
and announced to the staff how proud she was of herself for making so much positive forward progress.
Quickly the young
woman who was in charge of the billing processes spoke out sharply, stating, "You had better hope you're getting it together!
How can you expect to survive in today's world if you don't get a grip on yourself?"
The cutting tone of the young
woman's voice and the lack of knowledge and understanding concerning mental illness had surprised the patient. She had always
felt comfortable with the office staff, even surprising them with flowers for no special occassion in her quest to perform
random acts of kindness. She was always talking to people about how great her dentist office was tried to bring additional
customers to their practice.
Immediately the patient lost her breath as if someone had literally knocked the wind
out of her and she couldn't look at either of the office girls in her prescence. Quickly leaving the office, she could never
return. She lost track of her positive progress and regressed immediately. The cutting remarks had penetrated the newly formed
confidence of the patient and once again, she had felt herself falling into depression and panic. The exchange put her backwards
at least a year from the progress she had made.
In every avenue of today's life there are opportunities for the professional
community to come into contact with a person who is experiencing a mental illness. Perhaps it's time that employers, hospital
administrations, doctors' offices and even dentist, optometrist and counseling centers begin to teach their employees the
facts about mental illness. It's time that people were forced to become aware of what uneducated service workers might unknowingly
trigger in a mentally ill patient or patron. Even doctors' comments have been overheard by those experiencing mental illness
to be sharp, uncaring and uneducated thus, causing the triggering of additional symptoms to an already unhealthy situation.
Every person on this earth needs to begin to educate themselves if they intend on dealing with any type of public
affairs in their business, community or personal life. Just as we need to begin to educate ourselves on how to take care of
our planet, it's essential that we learn how to take care of each other. The numbers are staggering if you care to examine
them. You can realize the immensity of the problem by viewing any vital statistic material on the Internet concerning mental
health.
Those with mental illnesses may even be experincing physical illnesses due to the fact that their mental illness
had gone unrecognized and untreated. If, in fact, you are not ready to deal with the population that is experiencing a mental
illness, you may want to stop all business affairs until you can learn more about dealing with people who need to be treated
with respect, care and dignity instead of hurting someone unintentionally that is already suffering.
If, in fact, you
are selling products to the public that might not be usuable by those with a mental illness; it's time to think about how
to qualify that population. Nothing is as embarrassing than to be dealing with someone that you would like to purchase a self
help product from and then find out that their product is ineffective if you have been diagnosed with an anxiety disorder
and/or depression. Not only is it embarrassing, it triggers those who aren't ready to recognize their own triggers when someone
is being humiliated or intimidated by an uneducated salesperson.
Believe me, this type of personal interaction is
detrimental to those trying desperately to recover from a mental illness. It's time the reigns of professionalism are pulled
in tighter to include a public that is experiencing a mental illness - a disability - into their considerations for quality
customer service. Look for more of these articles and answers as to how to educate your administrators and employees in their
communications with a very up and coming population!
Author's
Bio: Kathleen Howe, a mother,
wife and writer has a network of self help sites that include information for those working in personal growth and recovery.
Sites cover a variety of topics that include life traumas and crises that Kathleen has experienced and recovered from herself.
Look for her new site which is about to open that covers the same topic that the article above covers - Dealing with the Emergence
of Mentally Ill Patients in the Medical and Mental Health Fields. It's about time the stigma was set aside! Also, visit her
existing network of sites anytime~! emotionalfeelings.tripod.com/emotional_feelings/index.html
just a special note to all my visitors...
do you have children or transport children?
click here... it's an emotional feeling "you tube video" that'll
cause you to be more careful in how you transport your child(ren).
God
Bless...
What Causes an Anxiety Disorder?
- By Deanne Repich
"What causes an anxiety
disorder? And which of these causes do I have control over?"
There are several factors that can contribute to an anxiety disorder. An anxiety disorder is caused by a combination of several
of these factors working together over a period of time. Usually one factor alone doesn't result in an anxiety disorder.
We all have an inborn "fight or flight" response designed
to protect us from harm. When our survival is threatened, the fight or flight response creates physical and psychological changes that encourage us to act and protect our survival. These changes include:
People suffering from
anxiety disorders often have a physical overreaction to stress. This overreaction occurs because your body perceives everyday events and situations as threats to survival. In an effort to protect you, your body triggers the fight or flight response even though no real danger exists.
There's some indication that an overreaction to
stress is caused by a chemical imbalance in the brain. However, we don't know what initially causes this chemical imbalance.
It hasn't been proven which occurs first - the overreaction
to stress that causes the chemical imbalance, or the chemical imbalance that causes the overreaction to stress.
Can I change it?: Yes. What's important to realize is that if you overreact to stress, you can learn to change it, no matter how it began.
When you experience excessive stress over time, your body can trigger the fight or flight response and start to react to
daily events as if they were dangers. Poor lifestyle habits such as overwork, lack of sleep, poor diet and lack of regular exercise can cause unnecessary stress and promote anxiety.
Let's look at an example of how stress overload and lifestyle factors can contribute to anxiety.
Donna works 70 hours a week for several years. This
puts excessive stress on Donna's body. To make matters worse, Donna is so busy working that she only manages to get 5 or 6 hours of sleep a night, she doesn't exercise regularly and she eats mainly fast food. She can't remember the last
time she took time out for herself.
Do you see how
Donna's lifestyle creates stress in her life and produces a negative snowball effect?
Over time Donna's
body starts perceiving these constant stressors as a threat to her survival. Her body eventually gets "burned out" from repeated unnecessary stress reactions.
It's on a constant state of alert - contributing to
the physical and mental symptoms of anxiety.
Can I change it?: Yes. You have the power to reduce or eliminate many of the stressors in your life. You do this by integrating healthy lifestyle habits - by making choices that promote calmness, self-care and a balanced lifestyle.
For example
Sleep 8 hours a night instead of 6.
Eat well-balanced, healthy meals.
Work 40-50 hours a week instead of 70 and so on.
You can also learn
to view stressors in a less anxious way so your body doesn't overreact to stressors when they occur.
Childhood Environment
Your childhood environment affects how you think and act as an adult. Even though the adults
around you meant well, as a child you may have learned habits and beliefs that contribute to anxiety.
For example, you
may not have been taught to have a sense of control over your world. You may have been expected to achieve as a way of gaining love and acceptance.
You may have been taught all or nothing thinking
or weren't allowed to freely express your feelings or opinions. You may have grown up in an environment that wasn't physically or emotionally safe. You may have been frequently judged or criticized. Or you may have grown up watching and modeling adults around you that reacted to life in an anxious way.
Can I change it?: Yes. No matter what your childhood environment was, you can change the anxiety-producing thought patterns and habits you learned then thru knowledge and practice.
How you think affects
how you view the world and how you react to stress. Negativethought patterns like "what-if" thinking, perfectionism, all or nothing thinking and victim talk can contribute to an anxiety disorder. In fact, negativethoughts can actually create physical symptoms in your body.
Can I change it?: Yes. Research shows that you have the power to change your thoughts, which can in turn affect how you physically and mentally feel. Through healther thoughts, you can learn to view the world in a less anxious way and feel better.
How do you change your thoughts? By using the three "R"s we discussed in the last newsletter: Recognize, Replace and Reinforce.
Genetic Factors
Research shows that
panic disorder and obsessive-compulsive disorder tend to run in families. Although there's some debate, it appears that part of this family tendency is due to how you're
brought up (environment) and part is due to genetics. There is some indication
that genetic factors are also involved in social anxiety.
Can I change it?: No. We can't change our genes. That's the bad news. Now here's the good news. You can positively change all of the other factors we discussed that contribute to anxiety.
And like we mentioned earlier, usually one factor
alone doesn't result in an anxiety disorder. This is exciting news! It means that if you learn to successfully address the other factors that contribute to anxiety, you can conquer your anxiety in spite of genetic factors.
Note: If you would like to learn skills to change how you react to stress, reduce the stress in your life, learn anxiety-fighting lifestyle habits and change your anxiousthought patterns and behaviors, try our Conquer Your Anxiety Success Program, available at: http://www.ConquerAnxiety.com.
The landmark study is described
in 4 papers that document the prevalence and severity of specific mental disorders. The
papers provide significant new data on the impairment - such as days lost from work - caused by specific disorders, including
mood, anxiety and substance abuse disorders.
These measures will allow
researchers to determine the degree of disability and the economic burden caused by mental illness,
as well as trends over time.
The papers are reported in
the June 6 issue of the Archives of General Psychiatry by Ronald Kessler, Ph.D. and colleagues. The study was
a collaborative project between Harvard Univ., the Univ. of Michigan and the NIMH Intramural Research Program.
This study, called the National
Comorbidity Survey Replication (NCS-R), is a household survey of 9,282 English-speaking
respondents, age 18 and older. It's an expanded replication of the 1990 National Comorbidity Survey, which was the 1st to
estimate the prevalence of mental disorders (using modern psychiatric
standards) in a nationally representative sample.
The expansion includes detailed
measures that will significantly improve estimates of the severity and persistence of mental disorders
and the degree to which they impair individuals and families and burden employers and the U.S. economy.
"These studies confirm a growing
understanding about the nature of mental illness across the lifespan," says Thomas Insel, M.D., Director
of the National Institute of Mental Health.
"There are many important messages from this study, but perhaps none as important as the recognition that mental disorders are the chronic disorders
of young people in the U.S."
Prevalence & Age-of-Onset
of Mental Disorders
Unlike most disabling
physical diseases, mental illness begins very early in life.
1/2 of all lifetime
cases begin by age 14; 3/4 quarters have begun by age 24. Thus, mental disorders are really
the chronic diseases of the young.
For example, anxiety disorders often begin in late childhood, mood disorders in late adolescence & substance abuse in the early 20's. Unlike heart disease or most cancers, young people with mental disorders suffer disability when they're in the prime of
life, when they would normally be the most productive.
The risk of mental disorders
is substantially lower among people who have matured out of the high-risk age range. Prevalence increases from the youngest
group (age 18-29) to the next-oldest age group (age 30-44)
& then declines, sometimes substantially, in the oldest group (age 60 +).
The survey found that in the
U.S., mental disorders are quite common; 26% of the general population reported that they
had symptoms sufficient for diagnosing a mental disorder during the past 12 months. However, many of these cases are mild
or will resolve without formal interventions.
It's likely, however, that
the prevalence rates in this paper are underestimated, because the sample was drawn from listings of households & didn't
include homeless & institutionalized (nursing homes, group homes) populations.
In addition, the study didn't
assess some rare & clinically complex psychiatric disorders, such as schizophrenia & autism, because a household survey
isn't the most efficient study design to identify & evaluate those disorders.
The study documents
the long delays between the onset of a mental disorder & the first treatment contact, as well as the accumulated burden
& hazards of untreated mental disorders.
These pervasive delays in getting treatment tend to occur for nearly all mental disorders, though they vary according
to specific diagnostic categories. The median delay across disorders is nearly a decade; the longest delays are 20-23
years, for social phobia & separation anxiety disorders. This is possibly due to the relatively early age of onset & fears of therapy that involve social interactions.
Shorter delays between onset
of disorder & treatment seeking - still a protracted 6 - 8 years - are seen for mood disorders & are likely attributable to public awareness campaigns, the marketing of newer therapies directly to consumers & expanded insurance coverage.
While approximately 80% of all people in the U.S. with a mental disorder eventually seek treatment, there
are public health implications from such long delays in treatment.
Untreated psychiatric disorders
can lead to more frequent & more severe episodes & are more likely to become resistant to treatment.
In addition, early-onset mental
disorders that are left untreated are associated with:
"The
pattern appears to be that the earlier in life the disorder begins, the slower an individual is to seek therapy & the
more persistent the illness," said Dr. Kessler, a professor of health care policy at Harvard Medical School. "It's unfortunate that those who most need treatment are the least likely to get it."
Treating cases early could
prevent enormous disability, before the illness becomes more severe & before co-occurring mental illnesses develop, which
only become more difficult to treat as they accumulate, according to the researchers.
Severity & Comorbidity of Mental Disorders
The second paper reports
that even though mental disorders are widespread throughout the population, the main burden of illness is concentrated in
those with a severe disorder - about 6%.
A "serious" disorder
involves a substantial limitation in daily activities or work disability, or a suicide attempt with serious lethal intent,
or psychosis. The serious group reported a mean of 88.3 days - nearly 3 months of the year - when they were unable to carry out their normal daily activities.
Unfortunately, say the researchers,
individuals with 1 mental disorder are at a high risk for also having a 2nd one (comorbidity).
Nearly 1/2 (45%) of those with one
mental disorder met criteria for two or more disorders, with severity strongly related to comorbidity. This finding
supports the suggestion by a growing portion of researchers that the boundaries between some diagnostic categories may be
less discrete than previously believed.
Use of Mental Health
Services The study indicates that the U.S. mental health care system isn't keeping up with the needs of consumers & that improvements are needed to speed initiation of treatment as well as enhance the quality & duration of treatment.
For instance, over a 12-month period, 60% of those with a mental disorder got no treatment at all.
The good news is that the
proportion of people who reported 12-month mental health service use is higher now - at 17% - than a decade ago in the baseline
NCS survey, at 13%. The expansion was mainly in the general medical sector, with more primary care physicians providing psychiatric
services.
People with mental or substance abuse disorders were more likely to get treatment from:
a primary care physician/nurse or other general medical doctor
(22.8%)
from a non-psychiatrist mental health specialist (16%)
a psychologist, social worker, or counselor, than from a psychiatrist
(12%)
though the survey did show that the adequacy of treatment -
measured by number of visits - is best when provided by mental health practitioners.
About 9.7% sought help from
a counselor or spiritual advisor outside of a mental health setting;
& 6.9% used a complementary-alternative source, such as a chiropractor or self-help group.
This held true even for those
with severe mood disorders. Traditionally underserved groups, such as the elderly, racial/ethnic minorities & those with low income or without insurance, had the greatest unmet need for treatment.
Future & Ongoing Efforts
The NIMH epidemiological
research portfolio contains several related projects that are focused on mental disorders among adolescents & ethnic subgroups. These include
1) an arm of the
NCS-R that is studying 10,000 youths
2) the National
Study of African American Life, with 6,000 participants
3) the National
Study of Latino & Asian Americans, with 5,000 participants
Each of these,
like the NCS-R, will provide information on diagnosis, medications, disability / impairment & service use, drawing from
nationally based samples.
An international perspective
on these findings is also becoming available, as the study is part of a global initiative on the epidemiology of mental disorders
in 28 countries, coordinated through the World Health Organization.
The Impact of Mental Illness on Society
"...the burden of psychiatric conditions has been heavily underestimated..."
The burden of mental illness
on health & productivity in the U. S. & throughout the world has long been underestimated. Data developed by the massive
Global Burden of Disease study conducted by the World Health Organization, the World Bank & Harvard University,
reveal that mental illness, including suicide, accounts for over 15% of the burden of disease in established market economies, such as the U.S.
This is more than the disease burden caused by
all cancers.
This Global
Burden of Disease study developed a single measure to allow comparison of the burden of disease across many
different disease conditions by including both death & disability.
This measure was called Disability
Adjusted Life Years (DALYs). DALYs measure lost years of healthy life regardless of whether the years were lost to
premature death or disability. The disability component of this measure is weighted for severity of the disability. i.e.,
disability caused by major depression was found to be equivalent to blindness or paraplegia whereas active psychosis seen in schizophrenia produces disability
equal to quadriplegia.
The projections show that
with the aging of the world population & the conquest of infectious diseases, psychiatric & neurological conditions
could increase their share of the total global disease burden by almost half, from 10.5% of the total burden to almost 15%
in 2020.
Facts
Major depression is the leading cause of disability
(measured by the number of years lived with a disabling condition) worldwide among
persons age 5 and older.
For women throughout the world as well as those in established
market economies, depression is the leading cause of DALYs. In established market economies, schizophrenia & bipolar disorder are also among the top 10 causes of DALYs for women.
A Child's Death Increases Parents' Risk of Mental Illness
By Peggy Peck, Senior Editor, MedPage Today March 23, 2005 Also covered by: Fox News , MSN , New York Times
Bereaved parents, especially parents of children
who die unexpectedly, are at increased risk of developing a number of mental disorders,
especially affective disorders.
Research
suggests that mothers have a greater risk than fathers. Encourage both parents to seek professional help following the death
of a child, but closely monitor mothers.
Review LOS
ANGELES - When a child dies - especially when the death is unexpected - surviving parents
have a 67% higher risk of hospitalization for mental illness
than do parents who never experience the death of a child.
What's more, mothers are especially
vulnerable, Jørn Olsen, MD, PhD and colleagues reported in Thursday's New England Journal of Medicine.
The likelihood that grieving mothers will be hospitalized for affective disorders such as clinical depression, bipolar disorder or anxiety is almost twice that of mothers who don't experience the death of child, says Dr. Olsen, who is chairman of epidemiology
at the UCLA School of Public Health.
He says that for mothers this
increased risk was almost double (91% greater) than of mothers who didn't lose a child.
The risk is greatest during the first year after the child dies but remained significantly elevated 5 years or more after
the death.
"We also found a dose
effect - mothers who lose more than one child, have a greater risk," he says.
For fathers, the risk of a
mental health hospitalization is 61% higher than for fathers who don't lose a child, says
Dr. Olsen.
Coincidentally, the study
comes at a time when the nation is riveted by 2 news stories of struggling parents: Bob and Mary Schindler who continue a
legal crusade to keep their brain damaged daughter alive.
At the same time, there are
the grieving parents of 6 high school students who were killed Monday in a shooting incident at Red Lake High School in Red
Lake, Minn.
Dr. Olsen says
the study results suggest the need for close monitoring of parents of the slain high school students because parental bereavement risks are greatest when death
occurs suddenly.
Elizabeth Berger MD, speaking
for the American Psychiatric Association, says the study findings confirm her own observations from years of practice. "The
loss of a child is uniquely devastating," she said. "It is the worst thing."
Dr. Berger, who is the author
of "Raising Children With Character," says the "take home message for physicians is that the bereaved parents remain an at
risk group on all measures - psychiatric hospitalization is just one crude measure of this continuing risk."
The mental illness
study is the last in a series of studies by Dr. Olsen and a team researchers from Denmark, all of which investigated
the "the general hypothesis of whether stress could trigger mental or physical disorders."
He says they decided to investigate
bereaved parents because it was considered "the highest stress exposure."
In earlier papers they reported
increased risk of mortality - especially accidental death and suicide and increased risk of cardiovascular disease among bereaved parents. In both cases, Dr. Olsen says, the increased risk was greatest for mothers.
In this study, Dr. Olsen's
team identified 1,082,503 persons who were born in Denmark from 1952 to 1999 and who had a child 18 years old or younger during
the study period from 1970 to 1999. Birth and death registries as well as medical records were analyzed to confirm childhood
mortality and health status of parents.
Among the findings:
Compared with
parents who didn't lose a child, parents who lost a child had an overall risk of first psychiatric hospitalization for any
disorder of 1.67 (95% CI 1.53-1.83).
Bereaved mothers had a higher
risk for any psychiatric hospitalization: 1.78 compared with bereaved fathers 1.38.
For bereaved mothers risk
of hospitalization for affective disorders is 1.91 (95% CI 1.59 to 2.30) vs. 1.61 (95% CI 1.15 to 2.27) for grieving fathers.
Dr. Olsen says the study has
a number of limitations that may over-estimate or underestimate the effect of a child's death: The authors couldn't adjust
for family history of psychiatric illness or socioeconomic status - both factors that could bias the results.
"Confounding might also be
possible it a shared genetic predisposition led to both the death of the child and psychiatric hospitalization in the
parent…" the authors write.
As the study included only
patients who were hospitalized, it's possible that it underestimated incidence rates for overall psychiatric illness.
The study was supported by grants form the Danish National Research
Foundation & the Danish Medical Research Council to the Danish Epidemiology Science Center & the National Center for
Register-Based Research.
Parents Report Estimated 2.7 Million Children with Emotional & Behavioral Problems
July 20, 2005
A special feature in the report,
America's Children: Key National Indicators of Well-Being 2005 shows that nearly 5% - or
an estimated 2.7 million children - are reported by their parents to suffer from definite or severe emotional or behavioral
difficulties, problems that may interfere with their family life, their ability to learn & their formation of friendships.
These difficulties may persist
throughout a child's development & lead to lifelong disability, including more serious illness, more difficult to treat
illness & co-occurring mental illnesses.
This special child mental
health indicator is based on responses from a sample of parents of children ages 4 - 17. They were asked to rate their child's
difficulty with emotions, concentration, behavior & ability to get along with other people.
"Parents are usually the first
to notice emotional & behavioral difficulties in their children," said Thomas R. Insel, M.D., Director of the National
Institute of Mental Health of the National Institutes of Health.
This indicator reports that
65% of parents of children with definite or severe difficulties had contacted a mental health professional or general doctor, or that their child had received special education services, for emotional or behavioral problems.
9% of parents of these children
said that they wanted mental health services for their child but were unable to afford them.
Parents also reported:
Boys were more likely than
girls to have definite or severe emotional & behavioral difficulties.
Children ages 8 & over
were more likely than younger children to have emotional or behavioral difficulties.
Children from poor families
were more likely to have emotional or behavioral difficulties than other children.
The
information for this special feature, Parental Reports of Emotional & Behavioral Difficulties, was contributed by experts
from the National Institute of Mental Health, the Center for Mental Health Services in the Substance Abuse & Mental Health
Services Administration, the National Center for Health Statistics, the National Center for Birth Defects & Developmental
Disabilities & an international panel.
It
was compiled from responses to an item in a child behavioral assessment instrument administered as part of the National Health
Interview Survey, conducted by the National Center for Health Statistics. The survey doesn't predict or provide information
on specific disorders.
Depression, Anxiety, Stress and Substance Abuse in America by Kellen Von Houser
Tim Ferriss, the author of "The 4-Hour Work Week" has posted
some interesting stats on his blog about work and American life.
63% of all employees
want to work less, up from 46% in 1992.
26% of adult Americans report being on the verge of a serious nervous
breakdown.
40% of workers describe their office environment as “most like a real-life survivor program.”
Only
14% of Americans take two weeks or more at a time for vacation. The average American therefore spends more time in the
bathroom than on vacation.
61% of Americans check email while on vacation.
53% of employees would
opt for a personal assistant rather than personal trainer.
62% of workers routinely end the day with work-related
neck pain, 44% report strained eyes, 38% complain of hand pain, and 34% report difficulty in sleeping due to work-related
stress.
88% of employees say they have a hard time juggling work and life.
70% of working fathers
and working mothers report they don’t have enough time for their children.
In 2005, a psychiatrist at King’s
College in London administered IQ tests to three groups: the first did nothing but perform the IQ test, the second was distracted
by e-mail and ringing phones, and the third was stoned on marijuana. Not surprisingly, the first group did better than the
other two by an average of 10 points. The e-mailers, on the other hands, did worse than the stoners by an average of 6 points.
Dr.
Richard Wolff, a professor of economics states in his online video, "Capitalism Hits the Fan", that Americans are working 20% more than they were 30 years
ago while Europeans are working 20% less. He also cites constantly increasing numbers of Americans taking psychiatric medications
and struggling with substance abuse.
It may be time for the American people to examine their values and determine if
their mental health might be more important than owning the latest, greatest new bit of technology or wearing designer clothing,
or having a new Hummer. And indeed, I see some who are. A recent article on the Examiner.com site, "Frugal is the New Sexy" discusses the new phenomena of people placing expensive purchases
in unmarked shopping bags and "closet shopping" to create a unique, signature style rather than purchasing the latest new
looks.
As Americans place value on things, hopefully they will more highly value people and relationships and our
dependence on psychiatric medications and substances to alter our moods will be replaced by socializing with friends spending
more time with our families. ANd perhaps Americans will become more active in electing officials who actually represent them
as opposed to politicians who serve corporate interests above human interests.
We can hope.
You can read more
about mental health issues on my blog at www.kellevision.com
Mental disorders
are common in the U.S. & internationally. An estimated 22.1% of Americans ages 18 &
older - about 1 in 5 adults - suffer from a diagnosable mental disorder in a given year.1
When applied
to the 1998 U.S. Census residential population estimate, this figure translates to 44.3 million
people.2
In addition,
4 of the 10 leading causes
of disability in the U.S. & other developed countries
are mental disorders - major depression, bipolar disorder, schizophrenia & obsessive-compulsive disorder.3 Many people suffer from more than one mental disorder at a given time.
In
the U.S., mental disorders are diagnosed based on the Diagnostic & Statistical Manual
of Mental Disorders, fourth edition (DSM-IV).4
Approximately 18.8 million
American adults,5 or about 9.5% of the U.S. population age 18 & older in a given year,1 have a depressive disorder.
Nearly twice as many women (12.%)
as men (6.6%) are affected by a depressive disorder each year. These figures translate to 12.4 million women & 6.4 million men in the U.S.5
Depressive disorder may be appearing earlier in life in people born in recent decades compared to the past.6
Major depressive disorder is the leading cause of disability
in the U.S. & established market economies worldwide.3
Major depressive disorder affects approximately 9.9 million
American adults,5 or about 5% of the U.S. population age 18 & older in a given year.1
Nearly twice as many women (6.5%)
as men (3.3%) suffer from major depressive disorder each year. These figures translate to 6.7 million women & 3.2 million men.5
While major depressive disorder can develop at any age, the
average age at onset is the mid-20's.4
Symptoms of dysthymic disorder (chronic,
mild depression) must persist for at least 2 years in adults (1 year in children)
to meet criteria for the diagnosis. Dysthymic disorder affects approximately 5.4% of the U.S. population age 18 & older
during their lifetime.1 This figure translates to about 10.9 million American adults.5
About 40% of adults with dysthymic disorder also meet criteria
for major depressive disorder or bipolar disorder in a given year.1
Schizophrenia often first appears earlier in men, usually in their late teens or early 20's, than in women, who are generally affected
in their 20's or early 30's.11
About 1 in 3 people with panic
disorder develop agoraphobia, a condition in which they become afraid of being in any place or situation where escape might be difficult or help unavailable in the event of a panic attack.11
Agoraphobia
involves intense fear & avoidance of any place or situation where escape might be difficult or help unavailable in the event of developing sudden panic-like
symptoms. Approximately 3.2 million American adults ages 18 to 54, or about 2.2% of people
in this age group in a given year, have agoraphobia.12
Specific phobia involves marked & persistent fear & avoidance of a specific object or situation. Approximately 6.3 million American adults ages 18 to
54, or about 4.4% of people in this age group in a given year, have some type of specific phobia.12
The 3 main types of eating
disorders are anorexia nervosa, bulimia nervosa & binge-eating disorder.
Females are much more likely than males to develop an eating
disorder. Only an estimated 5 - 15% of people with anorexia or bulimia18 & an estimated 35% of those with binge-eating disorder19 are male.
In their lifetime, an estimated 0.5% to 3.7% of females suffer
from anorexia & an estimated 1.1% to 4.2% suffer from bulimia.20
Community surveys have estimated that between 2% & 5% of
Americans experience binge-eating disorder in a 6-month period.19,21
The mortality rate among people with anorexia has been estimated
at 0.56% per year, or approximately 5.6% per decade, which is about 12 times higher than the annual death rate due to all
causes of death among females ages 15-24 in the general population.22
ADHD, one of the most common mental disorders in children & adolescents, affects an estimated 4.1% of youths ages 9 to 17 in a 6-month period.23
About 2 to 3 times more boys than girls are affected.24
ADHD usually becomes evident in preschool or early elementary
years. The disorder frequently persists into adolescence & occasionally into adulthood.25
Autism affects an estimated 1 to
2 per 1,000 people.26
Autism & related disorders (also
called autism spectrum disorders or pervasive developmental disorders) develop in childhood & generally are apparent by age 3.27
Autism is about 4 times more common
in boys than girls. Girls with the disorder, however, tend to have more severe symptoms & greater cognitive impairment.27
Alzheimer's disease, the most common cause of dementia among
people age 65 & older, affects an estimated 4 million Americans.
As more & more Americans live longer, the number affected
by Alzheimer's disease will continue to grow unless a cure or effective prevention is discovered.
The duration of illness, from onset of symptoms to death, averages
8 to 10 years.
the following web links are provided
for your convenience in visiting the source sites for the information displayed on this page:
Click here to visit the Red Cross page that allows you to access your local chapter of the Red Cross by entering your zip code in the
specified box, to see how you can help in your area. You can also call your local Red Cross Chapter that you can find the
number for online or in your local phone book to volunteer for any openings that may need to be filled or you can find another way to help others there as well!
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