Mental Health Stigma

According to a new survey from the National Institute on Mental Health, only about half of kids who suffer from mental health disorders are receiving treatment. One reason, experts say, is that too many of those kids and their families are embarrassed or ashamed.

When 12-year-old Nicholas was diagnosed with Attention Deficit Hyperactivity Disorder, his mother Martha was upset, and his father, Nick, resisted the diagnosis.

"I was kind of against that and felt like my son had a weakness," Nick says.

Martha remembers Nick's reaction when she told him of her son's illness. "'There is nothing wrong with my boy—perfect boy.'"

At first, Nick Senior didn't want his son on medication for a mental illness.

But with the help of his wife and other family members, Nick learned about and accepted his son's condition. Unfortunately, many parents aren't so easily convinced. They are caught up in what is known as the 'mental health stigma.'

"I call it prejudice," says Cynthia Wainscott of the National Mental Health Association. "And it leads to discrimination."

Experts say that discrimination, or the fear of it, is one of the leading reasons many illnesses go untreated. The problem is, if you don't call a child's problem by its right name other labels will be used.

"The child is labeled 'bad.' The child is labeled 'slow.' The child is labeled 'outside the circle,'" Wainscott says.

An untreated illness can lead a child to more serious problems, like severe depression or even suicide. Experts say that parents should learn about mental illness in children and accept that it is an illness, not a personal or parental shortcoming. Also, parents need to understand that it is a common illness—an estimated one in five children has a mental disorder.

Nicholas is comfortable with his diagnosis, "You don't need to go up to everybody hey 'my child has ADHD,' but you just let them find out," he says.

Although Marsha and Nick Rosner were shaken by Nicholas' diagnosis, they are glad that they found out and are confident that now, Nicholas is much better off.

"He's doing well in school and he's like the other kids," says Rosner.

All teens experience ups and downs. Every day poses a new test of their emotional stability – fighting with a friend, feeling peer pressure to "fit in" with a particular crowd or experiencing anxiety over a failed quiz – all of which can lead to normal feelings of sadness or grief. These feelings are usually brief and subside with time, unlike depression, which is more than feeling blue, sad or down in the dumps once in a while.

According to the Nemours Foundation, depression is a strong mood involving sadness, discouragement, despair or hopelessness that lasts for weeks, months or even longer. It also interferes with a person's ability to participate in normal activities. Often, depression in teens is overlooked because parents and teachers feel that unhappiness or "moodiness" is typical in young people. They blame hormones or other factors for teens' feelings of sadness or grief, which leaves many teens undiagnosed and untreated for their illness.

The Mayo Clinic reports that sometimes a stressful life event triggers depression. Other times, it seems to occur spontaneously, with no identifiable specific cause. However, certain risk factors may be associated with developing the disorder. Johns Hopkins University cites the following risk factors for becoming depressed:

• Children under stress who have experienced loss or who suffer attention, learning or conduct disorders are more susceptible to depression.
• Girls are more likely than boys to develop depression.
• Youth, particularly younger children, who develop depression are likely to have a family history of the disorder.

What We Need To Know

Signs of depression include:

• Prolonged sadness or unexplained crying spells
• Significant changes in appetite and sleep patterns
• Irritability, anger, worry, agitation or anxiety
• Pessimism or indifference
• Loss of energy or persistent lethargy
• Feelings of guilt and worthlessness
• Inability to concentrate and indecisiveness
• Inability to take pleasure in former interests or social withdrawal
• Unexplained aches and pains
• Recurring thoughts of death or suicide

It is important to acknowledge that teens may experiment with drugs or alcohol or become sexually promiscuous to avoid feelings of depression. According to the National Mental Health Association, teens may also express their depression through other hostile, aggressive, risk-taking behaviors. These behaviors will only lead to new problems, deeper levels of depression and destroyed relationships with friends and family, as well as difficulties with law enforcement or school officials.

The development of newer antidepressant medications and mood-stabilizing drugs in the last 20 years has revolutionized the treatment of depression. According to the Mayo Clinic, medication can relieve the symptoms of depression, and it has become the first line of treatment for most types of the disorder. Psychotherapy may also help teens cope with ongoing problems that trigger or contribute to their depression. A combination of medications and a brief course of psychotherapy are usually effective if a teen suffers from mild to moderate depression. For severely depressed teens, initial treatment usually includes medications. Once they improve, psychotherapy can be more effective.

Immediate treatment of your teen's depression is crucial. Adolescents and children suffering from depression may turn to suicide if they do not receive proper treatment. Suicide is the third leading cause of death for Americans aged 10-24. The National Association of School Psychologists suggests looking for the following warning signs that may indicate your depressed teen if contemplating suicide:

• Suicide notes: Notes or journal entries are a very real sign of danger and should be taken seriously.
• Threats: Threats may be direct statements ("I want to die." "I am going to kill myself") or, unfortunately, indirect comments ("The world would be better without me." "Nobody will miss me anyway"). Among teens, indirect clues could be offered through joking or through comments in school assignments, particularly creative writing or artwork.
• Previous attempts: If your child or teen has attempted suicide in the past, a greater likelihood that he or she will try again exists. Be very observant of any friends who have tried suicide before.
• Depression (helplessness/hopelessness): When symptoms of depression include strong thoughts of helplessness and hopelessness, your teen is possibly at greater risk for suicide. Watch out for behaviors or comments that indicate your teen is feeling overwhelmed by sadness or pessimistic views of his or her future.
• "Masked" depression: Sometimes risk-taking behaviors can include acts of aggression, gunplay and alcohol or substance abuse. While your teen does not act "depressed," his or her behavior suggests that he or she is not concerned about his or her own safety.
• Final arrangements: This behavior may take many forms. In adolescents, it might be giving away prized possessions, such as jewelry, clothing, journals or pictures.
• Efforts to hurt himself or herself: Self-injury behaviors are warning signs for young children as well as teens. Common self-destructive behaviors include running into traffic, jumping from heights and scratching, cutting or marking his or her body.
• Changes in physical habits and appearance: Changes include inability to sleep or sleeping all the time, sudden weight gain or loss and disinterest in appearance or hygiene.
• Sudden changes in personality, friends or behaviors: Changes can include withdrawing from friends and family, skipping school or classes, loss of involvement in activities that were once important and avoiding friends.
• Plan/method/access: A suicidal child or adolescent may show an increased interest in guns and other weapons, may seem to have increased access to guns, pills, etc., and/or may talk about or hint at a suicide plan. The greater the planning, the greater the potential for suicide.
• Death and suicidal themes: These themes might appear in classroom drawings, work samples, journals or homework.

If you suspect suicide, it is important to contact a medical professional immediately. A counselor or psychologist can also help offer additional support.

Resources

• American Academy of Child and Adolescent Psychiatry
• American Foundation for Suicidal Prevention
• Johns Hopkins University
• Mayo Clinic
• National Association of School Psychologists
• National Depressive and Manic-Depressive Association
• National Institute of Mental Health
• National Mental Health Association
• Nemours Foundation
• Thomson-Reuters

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