Depression rates among children rising, experts warn
By KEVIN SPURGAITIS
An estimated 10 to 20 per cent of all Canadian youths now suffer from a mental, emotional or behavioural disorder, which can seriously affect their daily functioning at home, school or within the community, mental health experts say.
Major depression is one of the most common mental health disorders that surface during childhood and adolescence, impacting a young person’s thoughts, feelings, behavior and body. More than “just the blues,” serious depression is widely misunderstood and often goes untreated, according to Children’s Mental Health Ontario (CMHO), one of Canada’s leading advocates for young people with mental health disorders and illnesses. Working with many partners, including the Ontario’s Ministry of Children and Youth Services, the CMHO also supports clinicians at children’s mental health centres throughout the province. These centres annually provide treatment and support to about 153,000 Ontario youth with mental health issues.
According to the CMHO, about five per cent of children and adolescents go through depression before the age of 19. It can drive sufferers to school failure, alcohol and drug abuse and suicide, which is the second leading cause of death for youth aged 15 to 24 in Canada. Having a family history of depression significantly increases the chances that a young person may develop the mental illness. Once a young person has experienced a major depression, they are also at risk of developing another depression or related mental health disorder within five years.
Usually persisting for two weeks, depression is characterized by temporary feelings of worthlessness and self-blame. Sufferers have a hard time coping with everyday activities and responsibilities, as well as getting along with others. The warning signs include irritability, depressed mood, persistent sadness, fatigue, loss of enjoyment in favorite activities, poor concentration, eating and sleeping, as well as thoughts of death. They may cry a lot, have more tantrums than usual and generally seem withdrawn.
“All mental health issues are best identified early. Children develop quickly and delays in identification and treatment may result in additional pain and distress for everyone and lifelong impairments,” said Richard Schwindt, the director of services at Pathways for Children and Youth, a children’s mental health agency in Kingston, Ont.
Parents are encouraged to take notes about their child’s behaviours and ask questions, before making an appointment with a mental health professional or a family doctor for evaluation and diagnosis. As well, they should talk to other families in their community.
Available to a young person with depression are several types of antidepressant medications, which should be carefully monitored. Additionally, mental health-care providers use “talk” treatments — a plan of care based on the severity and duration of symptoms. This system of care is designed to improve the child’s ability to function at home, at school and in the community.
Schwindt said “advances in knowledge, research and emphasis on evidence-based approaches has improved the ability to offer effective help to children and youth.”
“It is frightening when you do not understand an illness in the family. And education in that illness helps family members to develop ways and means of supporting and coping with their loved ones condition.”
Psychiatrist Margaret Steele, who specializes in depressive illness at London Ont.’s Health Sciences Centre, maintained that awareness can reduce the stigma of mental health problems.
“Children and youth are often worried they will be ridiculed or treated differently by peers, teachers, coaches and others. Parents are protective of their children and they do not want their children to be stigmatized or embarrassed,” Steele said.
“ … But if they understand their mental health problem and receive adequate treatment, they can live healthy, happy and productive lives.”
Experts say parents should heed warning signals of early onset schizophrenia
By KEVIN SPURGAITIS
An estimated 10 to 20 per cent of all Canadian youths now suffer from a mental, emotional or behavioural disorder, which can seriously affect their daily functioning at home, school or within the community, mental health experts say.
Schizophrenia is one serious mental illness that often goes untreated, according to Children’s Mental Health Ontario (CMHO), one of Canada’s leading advocates for young people with mental health disorders and illnesses. Working with many partners, including the Ontario’s Ministry of Children and Youth Services, the CMHO also supports clinicians at children’s mental health centres throughout the province. These centres annually provide treatment and support to about 153,000 Ontario youth with mental health issues.
Affecting one per cent of the Canadian population — most often people between 16 and 30-years-of-age — schizophrenia has been described as young people’s “greatest disabler.” This biological brain disorder may seem like a puzzle at first, but pieces are continually falling into place in the field of psychiatric research, the CMHO reports. Today, there is strong evidence that suggests the condition is genetic and runs in families.
Schizophrenia often starts slowly, first appearing in adolescence or early adulthood.
During the early stages, people with schizophrenia may find themselves losing the ability to relax, concentrate or sleep. They may even shun long-time friends. Eventually, their work or education may be affected, as well as their personal appearance. They ultimately suffer delusions or visual and auditory hallucinations — disorganized thinking that makes sufferers feel “mixed up” and even suicidal.
“The young, schizophrenic population may feel quite fragile and hollow on the inside. They have an inordinately difficult time coming to terms with their illness,” said Michael Shaughnessy, the clinical director of Central Toronto Youth Services. “Having them recognize that is a major step forward, though. We can help them make better choices in their own lives and negotiate their days.”
A number of antipsychotic medications can help alleviate biochemical imbalances in many people with schizophrenia. It lessens hallucinations and delusions. Families can also be a big help, mental health experts agree. Working closely with health-care professionals, family members can learn more about the illness. In turn, they can provide useful information to clinicians. They can find ways to support their children with schizophrenia and provide a nurturing, less stressful living environment for them.
With proper and improved medication, skilled psychotherapy and the support of family, friends and mental health professionals, young people with schizophrenia can live fairly independently, according to Shaughnessy, who has worked with at-risk youths for more than 14 years.
“The access is there. There are the ‘silk roads’ of emergency and in-patient care for this population — some who claim they are the son of God and will change the rules of the world … They don’t have to regress into a life of criminal activity.”
Meanwhile, the search for a cure continues, Shaughnessy said.
Eating disorders on the rise among Canadian teens — experts
By KEVIN SPURGAITIS
An estimated 10 to 20 per cent of all Canadian youths now suffer from a mental, emotional or behavioural disorder, which can seriously affect their daily functioning at home, school or within the community, mental health experts say.
Eating disorders are some of the most common psychiatric conditions that often go untreated, according to Children’s Mental Health Ontario (CMHO), one of Canada’s leading advocates for young people with mental health disorders and illnesses. Working with many partners, including the Ontario’s Ministry of Children and Youth Services, the CMHO also supports clinicians at children’s mental health centres throughout the province. These centres annually provide treatment and support to about 153,000 Ontario youth with mental health issues.
The eating disorders, anorexia nervosa and bulimia, are on the rise among Canada’s teenage girl population. The CMHO reports that anorexia affects one in every 100 to 200 adolescent females and some boys. An estimated one to three of every 100 young people suffer from bulimia. Usually dangerously underweight, a teen who has either disorder is a perfectionist who suffers from low self-esteem and harbours an “un-real” belief of being overweight, regardless of how thin they are. Anorexics are characterized by their staunch refusal to consume foods. Individuals with bulimia are distinguished by their uncontrolled binge eating and forced vomitting. They may initially lose weight, but will often regain it because of the ineffectiveness of purging methods.
There is no single cause. Mental health experts, however, believe age, gender, psychology, socio-economics, culture, ethnicity, religion, relationships with family and friends, as well socially constructed ideals concerning beauty and body image all play a role in a young person’s development of the disorder. Biochemical or biological causes are also being studied.
Warning signs of eating disorders are marked by weight loss or gain; sensitivity to cold fatigue; skin and nail problems; disruption in bowel functioning; swollen salivary glands (puffy cheeks); irregular or absent menstruation; frequent dental problems; hair loss; insomnia and social isolation; avoidance of friends and family, and the refusal to answer the telephone or respond to mail.
It is highly important that parents nurture the self-esteem of their children, according to the Canadian Mental Health Association (CMHA). “It is never too early to consider children’s mental health. Parents play a crucial role in guiding the development of their child’s self-confidence and emotional strength and balance. But, as they say, children don’t come with a manual. And parents can’t always recall how they felt and thought when they were children,” the CMHA said in a statement.
“(Mental health) means striking a balance in all aspects of one’s life: social, physical, spiritual, economic and mental. At times, the balance may be tipped too much in one direction and one’s footing has to found again. Everyone’s personal balance is unique and the challenge is to stay mentally healthy by keeping the right balance.”
However, young people with an eating disorder usually work very hard to keep it a secret. In addition, diagnosis of the disorder can be difficult, because its symptoms often occur in combination with depression, anxiety and substance abuse. Contrary to belief, though, this mental malady is too big for young people to fix on their own. The sooner they seek help for their eating disorder, the sooner they will benefit from treatment.
Though no one can force their child to change their behaviour, they can be supportive and encourage young people to seek professional help. Eating disorder specialists caution parents to focus their discussions on feelings, not food. The most effective treatment path is a multi-disciplinary approach, involving a thorough medical assessment and nutritional guidance, followed by a medical check-up and individual, group and family therapies. Because eating disorders have a profound negative impact on all family members, the entire family may need counselling.
Generally, bodies come in many different shapes and sizes and everyone deserves to be respected, mental health experts say.
Parents should seek help for child’s conduct disorder, mental health experts warn
By KEVIN SPURGAITIS
An estimated 10 to 20 per cent of all Canadian youths now suffer from a mental, emotional or behavioural disorder, which can seriously affect their daily functioning at home, school or within the community, mental health experts say.
Children and adolescents with conduct disorder (CD), in particular, repeatedly violate the personal or property rights of others — and the overall expectations of society, according to Children’s Mental Health Ontario (CMHO), one of Canada’s leading advocates for young people with mental health disorders and illnesses. Working with many partners, including the Ontario’s Ministry of Children and Youth Services, the CMHO also supports clinicians at children’s mental health centres throughout the province. These centres annually provide treatment and support to about 153,000 Ontario youth with mental health issues.
CD is known as a “disruptive behavior disorder,” because of its impact on children and their families, neighbors, and educators. An estimated three to five Canadian children out of every 100 has the disorder, the CMHO reports. Generally, it affects those between nine and 17-years-of-age, especially at-risk children and adolescents living in cities. Sometimes occurring alongside attention deficit hyperactivity disorder (ADHD), CD develops in early childhood and often during preschool years. Research shows that children are susceptible if they experience early maternal rejection; separation from parents without an adequate alternative caregiver; early institutionalization; family neglect; abuse or violence; parental mental illness; parental marital discord; overcrowding and poverty.
A child with CD experiences both emotional and behavioural problems, leading them to take dangerous risks. Those with CD may appear “fussy,” hostile and defiant, having difficulty following the rules and behaving in a socially acceptable way. If left untreated, it can lead to depression and suicidal tendencies; sexually transmitted diseases; drug and alcohol abuse; injuries, school expulsions and criminal activity.
“The individual with CD may not be the one asking for help and may only be impacted when they are socially sanctioned for their behaviours. Others are the victims,” said Barrie Evans, executive director of London Ont.’s Madame Vanier Children’s Services. “However, in a philosophical, spiritual and humanistic sense, they suffer because they do not enjoy the full richness of life. They are not in peace with themselves and with others.”
Aggression peaks normally in ‘toddlerhood,’ but research shows that children have to be actively taught to control aggressive impulses, according to Evans, who is also a psychology professor at the University of Western Ontario\.
He encourages parents to pay close attention to the early warning signs of the disorder. They should talk with a mental health or social services professional, such as a teacher, counselor, psychiatrist, or psychologist specializing in childhood and adolescent disorders. As well, parents are advised to talk to other families in their communities.
Although conduct disorder is one of the most difficult behavior disorders to treat, young people often benefit from a range of community-based treatment, including family therapy and training in problem solving skills, as well as medication helping to manage aggression. If they are not satisfied with the mental health services they receive, they should discuss their concerns with their mental health-care provider, or seek help from other sources.
They may not be sufficient to deal with every case, but for the most part, Ontario’s mental health centres have a variety of health and youth programs, Evans maintained.
“Health programs should work along with child protection in regards to early onset and with youth justice in regard to adolescent onset … (Mental health professionals) are prepared to help them to understand and cope with their feelings …”
Parents should heed warning signals of bipolar disorder, mental health experts warn
By KEVIN SPURGAITIS
An estimated 10 to 20 per cent of all Canadian youths now suffer from a mental, emotional or behavioural disorder, which can seriously affect their daily functioning at home, school or within the community, mental health experts say.
Bi-polar disorder is one mental health condition that often goes untreated, according to Children’s Mental Health Ontario (CMHO), one of Canada’s leading advocates for young people with mental health disorders and illnesses. Working with many partners, including the Ontario’s Ministry of Children and Youth Services, the CMHO also supports clinicians at children’s mental health centres throughout the province. These centres annually provide treatment and support to about 153,000 Ontario youth with mental health issues.
Developing in late adolescence or early adulthood, bipolar disorder or manic-depressive illness affects one per cent of the population, the CMHO reports. In some cases, drug abuse and traumatic episodes may be contributing factors. It is common for people to go through their emotional ‘ups and downs,’ but bipolar disorder causes dramatic mood swings, from overly high and irritable (mania) to sad and hopeless (depression). A young person can experience either depression or mania for several days to several months.
Young people with the disorder have described feeling like an all-powerful superhero with extraordinary powers. Surging in energy and having the ability to go with little or no sleep for days without feeling tired, bipolar sufferers are also known to talk too much and too fast. Their disorder may also lead them to high risk-taking behaviour, such as the abuse of alcohol and drugs, reckless driving or sexual promiscuity.
Depending on patients’ strengths and skills sets, along with family supervision, the condition is treatable, though. Clinical studies reveal that the majority of patients experience some relief from their symptoms after receiving medication and forms of counselling or psychotherapy. Sometimes, electroconvulsive therapy, or ECT, is used.
However, stigma still surrounds the mental health condition, and friends and family are encouraged to support those affected.
“It can be a crisis for the family, who are thrown back on their own resources to figure out what’s going on. They want to see their children grow up and get the very best,” said Michael Shaughnessy, the clinical director of Central Toronto Youth Services. “ … They need to identify the early-warning signs of their child’s psychosis.”
Specializing in the diagnosis and treatment of bipolar disorder and schizophrenia, Shaughnessy has worked with at-risk youths for more than 14 years. He maintained
mental health practitioners can better assist patients and their families negotiate bipolar disorder.
“If you don’t intervene aggressively early on and often, there is a substantial greater risk that their symptoms will grow and their delusions will harden, which then becomes a clinical issue for us.
“(Bipolar disorder) is debilitating at times. Young people with the condition simply want to be accepted and belong. They want to fit in … But there is hope that the deficits they have experienced can be turned around.”
Children’s anxiety disorders still prevalent in Canada — experts
By KEVIN SPURGAITIS
An estimated 10 to 20 per cent of all Canadian youths now suffer from a mental, emotional or behavioural disorder, which can seriously affect their daily functioning at home, school or within the community, mental health experts say.
Anxiety disorders remain some of the most common psychiatric conditions and also the least understood, according to Children’s Mental Health Ontario (CMHO), one of Canada’s leading advocates for young people with mental health disorders and illnesses. Working with many partners, including the Ontario’s Ministry of Children and Youth Services, the CMHO also supports clinicians at children’s mental health centres throughout the province. These centres annually provide treatment and support to about 153,000 Ontario youth with mental health issues.
People of all ages — including children — feel anxious from time to time. It is a normal reaction to stressful situations in a school environment, for example. These sensations, however, are different from the ones associated with an anxiety disorder. Conversely, people suffering from an anxiety disorder often experience intense, prolonged feelings of fright and distress for no particular reason. The condition can turn their life “upside down,” interfering with their relationships with family, friends and teachers, the CMHO reports.
Affecting approximately one in 10 people, especially females, and more than six per cent of children and adolescents, anxiety disorder is caused by a combination of biological factors and personal circumstances. Those with the mental health condition may also be diagnosed with having depression, eating disorders or substance additions, studies reveal.
Anxiety disorders range from feelings of uneasiness to immobilizing bouts with terror. There is panic disorder characterized by chest pain, heart palpitations, shortness of breath, dizziness, abdominal discomfort and a fear of dying. Social and specific phobias cause intense fear of being observed or of doing something horribly wrong in front of other people. The feelings are so extreme that people with phobias tend to avoid objects or situations altogether, dramatically reducing their ability to lead a normal life. On the other hand, post-traumatic stress disorder is created when someone is physically harmed or threatened. It is prevalent among survivors of rape, child abuse, war or a natural disaster. Symptoms include flashbacks during which the person re-lives the terrifying experience, nightmares, depression and feelings of anger or irritability.
Then there’s obsessive-compulsive disorder, a condition in which people suffer from persistent unwanted thoughts (obsessions) or even rituals (compulsions) they simply cannot control. These include habitual washing, checking, organizing and counting.
Lastly, generalized anxiety disorder sees sufferers worrying incessantly about routine events and activities. Persisting for at least six months, it makes individual nauseous, tremble, lethargic and ache.
For too often, though, anxiety may be mistaken for mental weakness or instability. The resulting social stigma can discourage children with anxiety disorders – and their parents — from seeking help. But if left untreated, it could lead to school absences, impaired relations with peers and low self-esteem.
“A proper diagnosis is key to putting a person with an anxiety disorder on the right treatment path, said Kevin Clouthier, executive director of Woodstock Ont.’s Oxford Child and Youth Centre.
Drug and cognitive-behavioural therapies (CBT) are a couple of remedies for anxiety disorder. Provided in tandem, these two interventions have the highest positive outcomes, Clouthier maintained. As well, support groups and educational resources can be included in treatment.
A specialist in children’s anxiety disorders, he said there are opportunities to work with people at an early age and divert problems from becoming a “lifestyle.” “Parents worry about their child’s wellbeing. It can dominate their thoughts and disrupt their routines. (Parents) may not understand what is occurring, but they will be motivated to explore what is happening.
He continued: “There is really no blame and with their love and caring, they can make good decisions (for their children) in the future … When all of these providers can come together in partnerships and offer assistance in collaboration, there is more coherent help provided. Working together is key.”
Parents should heed warning signals of child’s ADHD, mental health experts warn
By KEVIN SPURGAITIS
An estimated 10 to 20 per cent of all Canadian youths now suffer from a mental, emotional or behavioural disorder, which can seriously affect their daily functioning at home, school or within the community, mental health experts say.
Attention Deficit Hyperactivity Disorder (ADHD) is one common condition that often goes untreated, according to Children’s Mental Health Ontario (CMHO), one of Canada’s leading advocates for young people with mental health disorders and illnesses. Working with many partners, including the Ontario’s Ministry of Children and Youth Services, the CMHO also supports clinicians at children’s mental health centres throughout the province. These centres annually provide treatment and support to about 153,000 Ontario youth with mental health issues.
ADHD interferes with the learning process by reducing the child’s ability to pay attention. It occurs in between three and seven per cent of all children and youth, typically beginning before the age of seven and continuing well into adulthood. They may become inattentive, unable to focus their attention on any one thing, complete a task or learn something new. They may be overly impulsive, displaying emotions without any restraint and failing to wait their turn in games. As well, a child may start to be hyperactive, noticeably squirming and fidgetting in their seats, walking around the room or talking incessantly.
A school-aged child with ADHD faces challenges in school, finds it difficult to interact with classmates and has trouble at home. The disorder is characterized by frequent outbursts, insomnia, disinterest in personal appearance and weight obsession, as well as a general loss of appetite, energy and motivation. Children and adolescents with ADHD have been known to stop doing the things they enjoy most; abuse alcohol and drugs; damage other people’s property; bully other children or even injure themselves, according to the CMHO.
“At the higher end, the disorder can have a devastating impact,” said Cherry Murray, executive director of Ottawa’s Crossroads Children’s Centre. “The school environment, for example, is not well designed for children with ADHD. Their dropout rate is higher. Children and youth may have fewer friends or turn to inappropriate friends. Their poor social skills and failure experiences can add more problems to the mix — problems such as depression, anxiety, aggression, or defiance.”
Because ADHD is hard to spot, a child’s disruptive behaviour may not be investigated initially. Often dismissed as the ‘class clown’ or ‘class bully,’ they are likely to be excluded or blamed for their so-called “invisible illness.”
Members of their family are affected by the disorder, too. Parents often experience confusion, frustration and self-blame, wondering if they should have noticed the problem earlier and could have prevented it. They can feel sadness for their child, who may have trouble making and keeping friends. Additionally, grandparents may not be quick to babysit, for example, while siblings may find that their brother or sister with ADHD absorbs more than their share of attention, which can cut short family outings.
Murray said, “The exciting thing about children’s mental health is that we can teach parents sometimes fairly simple strategies that make a big difference. Recently one parent remarked that Crossroads helped me ‘learn to love my child again.’”
An increasing number of adults are now comfortable seeking help and talking about the disorder, she added. Today, there is more understanding and acceptance of those with ADHD. Parents are encouraged to dialogue with their child’s teacher and consult their family doctor, who can refer them to professionals who can better assess a child’s behaviour. Alternatively, people can contact a community organization dedicated to attention deficit disorders or learning disabilities.
Once a professional has completely evaluated a child and diagnosed their condition, the most appropriate treatment program can be chosen. A multidisciplinary — or team approach — by a children’s mental health centre makes all the difference in patients’ lives, Murray said. In addition to being prescribed medication, a child may be given social skills training, placed in support groups and provided with other therapies — all of which can have a “big impact.”
“ … Untreated and unsupported ADHD can have a devastating impact on the life of a child, youth and family. But with treatment, support, and understanding, individuals with ADHD can not only live very productive lives, the very energy and spontaneity that characterizes these individuals can lead them to make outstanding contributions.”
Children’s Mental Health Week is between May 7 and 13. Go to www.kidsmentalhealth.ca and learn more about ADHD, other common children’s mental health disorders and the children’s mental health centre (CMHC) serving your community.
Series originally published in Ontario community and city papers, May 2006
