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Understanding Mental Illness

There is much to understanding mental illness, what it is, and what it is not.

Jump to a topic:

What is Mental Illness?
Myths & Facts
Mental Illness in Children & Teens

What is Mental Illness?

Mental illnesses are conditions that reduce a person’s ability to cope with and manage the ordinary demands of life. Mental illnesses can disrupt a person’s thinking, feeling, mood, the ability to relate to others. Mental illnesses have different symptoms that require different treatment approaches. For example, a person with clinical depression may have a feeling of deep sadness and may need medication and/or therapy to treat symptoms. A person with schizophrenia may hear voices that create a threat to that person or others and may need to be hospitalized for a short amount of time to determine the medication and therapy needed for long-term help.

Serious mental illnesses include clinical depression, schizophrenia, bipolar disorder, obsessive-compulsive disorder (OCD), panic disorder, posttraumatic stress disorder (PTSD) and borderline personality disorder. The good news about mental illness is that recovery is possible, as 70 and 90 percent of people with mental illness have fewer symptoms with the right type and/or combination treatments like medications and psychosocial treatments and supports. Medications for mental illness help to eliminate the chemical imbalances identified as a cause of the illness.

Most people with mental illness live a fulfilling life, working full or part time jobs, going to school, volunteering, and remaining active in their community. The days of people staying in intuitions for long periods are for the most part over. Many programs help people with mental illness live on their own and support themselves, empowering them to have dignified, functional, and satisfying lives.

More Information About Mental Illnesses

Visit the webpage of the National Alliance for Research on Schizophrenia and Depression (NARSAD) for more information about mental illnesses. NARSAD recently has adopted the business name “NARSAD, The World’s Leading Charity Dedicated to Mental Health Research” to reflect the broader funding interests of the organization. In addition to funding research about schizophrenia and depression, NARSAD funds research such as childhood psychiatric disorders, bipolar disorder, and anxiety disorders.

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Myths & Facts

The following “Top 10 Myths about Mental Illness” is from a national survey published by NARSAD, the largest not-for-profit organization raising and distributing funds for psychiatric research. “Misconceptions about mental illness contribute to the stigma, which leads many people to be ashamed and prevents them from seeking help,” said Constance Lieber, NARSAD President. “Dispelling these myths is a powerful step toward eradicating the stigma and allaying the fears surrounding brain disorders.”

Myth: Psychiatric disorders are not true medical illnesses like heart disease and diabetes. People who have a mental illness are just “crazy.”

Fact: Brain disorders, like heart disease and diabetes, are legitimate medical illnesses. Research shows there are genetic and biological causes for psychiatric disorders, which can be treated effectively.

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Myth: People with a severe mental illness, such as schizophrenia, are usually dangerous and violent.

Fact: Statistics show that the incidence of violence in people who have a brain disorder is not much higher than it is in the general population. Those suffering from a psychosis such as schizophrenia are more often frightened, confused, and despondent than violent.

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Myth: Mental illness is the result of bad parenting.

Fact: Most experts agree that a genetic susceptibility, combined with other risk factors, often leads to a psychiatric disorder. In other words, mental illnesses often have a physical cause.

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Myth: Depression results from a personality weakness or character flaw, and people who are depressed could just snap out of it if they tried hard enough.

Fact: Depression has nothing to do with being lazy or weak. It results from changes in brain chemistry or brain function, and medication and/or psychotherapy often help people to recover.

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Myth: Schizophrenia means split personality, and there is no way to control it.

Fact: Schizophrenia is often confused with multiple personality disorder. Actually, schizophrenia is a brain disorder that robs people of their ability to think clearly and logically. The estimated 2.5 million Americans with schizophrenia have symptoms ranging from social withdrawal to hallucinations and delusions. Medication has helped many of these individuals to lead fulfilling, productive lives.

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Myth: Depression is a normal part of the aging process.

Fact: It is not normal for older adults to be depressed. Signs of depression in older people include a loss of interest in activities, sleep disturbances, and lethargy. Depression in the elderly is often undiagnosed, and it is important for seniors and their family members to recognize the problem and seek professional help.

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Myth: Depression and other illnesses, such as anxiety disorders, do not affect children or adolescents. Any problems they have are just a part of growing up.

Fact: Children and adolescents can develop severe mental illnesses. In the United States, one in ten children and adolescents have a mental disorder severe enough to cause impairment. However, only about 20 percent of these children receive needed treatment. Left untreated, these problems can get worse. Anyone talking about suicide should be taken very seriously.

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Myth: If you have a mental illness, you can will it away. Seeking treatment for a psychiatric disorder means an individual has in some way “failed” or is weak.

Fact: A serious mental illness cannot be willed away. Ignoring the problem does not make it go away, either. It takes courage to seek professional help.

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Myth: Addiction is a lifestyle choice and shows a lack of willpower. People with a substance abuse problem are morally weak or “bad”.

Fact: Addiction is a disease that generally results from changes in brain chemistry. It has nothing to do with being a “bad” person.

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Myth: Electroconvulsive therapy (ECT), formerly known as “shock treatment,” is painful and barbaric.

Fact: ECT has given a new lease on life to many people who suffer from severe and debilitating depression. It is used when other treatments such as psychotherapy or medication fail or cannot be used. Patients who receive ECT are asleep and under anesthesia, so they do not feel anything.

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Mental Illness in Children & Teens

Why be concerned and seek mental health treatment?

  • About 50% of young children with externalizing problems continue to have clinical problems in elementary school (these children are at greatest risk for developing conduct disorder).
  • With most internalizing problems, the earlier the onset, the greater the severity of the problem.
  • The earlier the intervention (including family therapy, play therapy, behavior management, and/or medication), the better the outcome for most mental health problems.

How to Determine When a Child Needs Clinical Attention:

  • When we see a pattern or constellation of problem behaviors.
  • The behavior is unusual for the child’s stage of development.
  • The pattern of symptoms is seen across settings.
  • The behaviors interfere with the child achieving developmental skills and participating in daily tasks.
  • The behavior problems occur frequently and/or with high intensity.
  • The behavior problems are stable for a period of time.

Your child’s mental health

Children face many pressures in our modern society. Most do fine, but some find it difficult to cope or do not get the support they need to feel safe, happy and confident. If your child is feeling distressed or troubled, they may express their unhappiness in a number of ways:

  • not sleeping, having nightmares, wetting the bed
  • becoming disruptive in class
  • getting fussy about food or cleanliness, or developing eating problems
  • becoming sad and depressed
  • trying to harm themselves
  • having trouble making friends, or finding relationships at home difficult
  • becoming fearful and resentful
  • getting into fights and becoming aggressive

Equally, your instincts may tell you there is something wrong. If you are worried about your child:

  • talk to your doctor or health care provider – they may refer you to special services in your area for children, young people and families
  • talk to your child’s school – the school may be able to help sort out difficulties, provide extra support and make allowances for your child

Should My Child See a Therapist?

Significant life events — such as the death of a family member, friend, or pet; divorce or a move; abuse; trauma; a parent leaving on military deployment; or a major illness in the family — can cause stress that might lead to problems with behavior, mood, sleep, appetite, and academic or social functioning. In some cases, it’s not as clear what has caused a child to suddenly seem withdrawn, worried, stress, sulky, or tearful. But if you feel your child might have an emotional or behavioral problem or needs help coping with a difficult life event, trust your instincts.

Signs that your child may benefit from seeing a psychologist or licensed therapist include:

  • developmental delay in speech, language, or toilet training
  • learning or attention problems (such as ADHD)
  • behavioral problems (such as excessive anger, acting out, bedwetting or eating disorders)
  • a significant drop in grades, particularly if your child normally maintains high grades
  • episodes of sadness, tearfulness, or depression
  • social withdrawal or isolation
  • being the victim of bullying or bullying other children
  • decreased interest in previously enjoyed activities
  • overly aggressive behavior (such as biting, kicking, or hitting)
  • sudden changes in appetite (particularly in adolescents)
  • insomnia or increased sleepiness
  • excessive school absenteeism or tardiness
  • mood swings (e.g., happy one minute, upset the next)
  • development of or an increase in physical complaints (such as headache, stomachache, or not feeling well) despite a normal physical exam by your doctor
  • management of a serious, acute, or chronic illness
  • signs of alcohol, drug, or other substance use (such as solvents or prescription drug abuse)
  • problems in transitions (following separation, divorce, or relocation)
  • bereavement issues
  • custody evaluations
  • therapy following sexual, physical, or emotional abuse or other traumatic events.

Pre-schoolers could benefit from seeing a developmental or clinical psychologist if there’s a significant delay in achieving developmental milestones such as walking, talking, and potty training, and if there are concerns regarding autism or other developmental disorders.

Talk to Caregivers, Teachers, and the Doctor

It’s also helpful to speak to caregivers and teachers who interact regularly with your child. Is your child paying attention in class and turning in assignments on time? What’s his or her behavior like at recess and with peers? Gather as much information as possible to determine the best course of action.

Discuss your concerns with your child’s doctor, who can offer perspective and evaluate your child to rule out any medical conditions that could be having an effect. The doctor also may be able to refer you to a qualified therapist for the help your child needs.

Finding the Right Therapist

How do you find a qualified clinician who has experience working with kids and teens? While experience and education are important, it’s also important to find a counselor your child feels comfortable talking to. Look for one who not only has the right experience, but also the best approach to help your child in the current circumstances.

Your doctor can be a good source of a referral. Most doctors have working relationships with mental health specialists such as child psychologists or clinical social workers. Friends, colleagues, or family members might also be able to recommend someone.

Consider a number of factors when searching for the right therapist for your child. A good first step is to ask if the therapist is willing to meet with you for a brief consultation or to talk with you during a phone interview before you commit to regular visits. Not all therapists are able to do this, given their busy schedules. Most therapists charge a fee for this type of service; others consider it a complimentary visit.

Factors to Consider

Consider the following factors when evaluating a potential therapist:

  • Is the therapist licensed to practice in your state? (You can check with the state board for that profession or check to see if the license is displayed in the office.)
  • Is the therapist covered by your health insurance plan’s mental health benefits? If so, how many sessions are covered by your plan? What will your co-pay be?
  • What are his or her credentials?
  • What type of experience does the therapist have?
  • How long has the therapist worked with children and adolescents?
  • Would your child find the therapist friendly?
  • What is the cancellation policy if you’re unable to keep an appointment?
  • Is the therapist available by phone during an emergency?
  • Who will be available to your child during the therapist’s vacation, illness or off-hours?
  • What types of therapy does the therapist specialize in?
  • Is the therapist willing to meet with you in addition to working with your child?

The right therapist–client match is critical, so you might need to meet with a few before you find one who clicks with both you and your child.

As with other medical professionals, therapists may have a variety of credentials and specific degrees. As a general rule, your child’s therapist should hold a professional degree in the field of mental health (psychology, social work, or psychiatry) and be licensed by your state. Psychologists, social workers, and psychiatrists all diagnose and treat mental health disorders.

It’s also a good idea to know what those letters that follow a therapist’s name mean:

Psychiatrists (MDs or DOs) are medical doctors who have advanced training and experience in psychotherapy and pharmacology. They can also prescribe medications.

Clinical psychologists (PhDs, PsyDs, or EdDs) are therapists who have a doctorate degree that includes advanced training in the practice of psychology, and many specialize in treating children, teens, and their families. Psychologists may help clients manage medications but do not prescribe medication.

A licensed clinical social worker (LCSW) has a master’s degree, specializes in clinical social work, and is licensed in the state in which he or she practices. An LICSW is also a licensed clinical social worker. A CSW is a certified social worker. Many social workers are trained in psychotherapy, but the credentials vary from state to state. Likewise, the designations (i.e., LCSW, LICSW, CSW) can vary from state to state.

Different Types of Therapy

There are many types of therapy. Therapists choose the strategies that are most appropriate for a particular problem and for the individual child and family. Therapists will often spend a portion of each session with the parents alone, with the child alone, and with the family together. Any one therapist may use a variety of strategies, including:

Cognitive behavioral therapy restructures negative thoughts into more positive, effective ways of thinking. It can include work on stress management strategies, relaxation training, practicing coping skills, and other forms of treatment.

Psychoanalytic therapy is less commonly used with children but can be used with older kids and teens who may benefit from more in-depth analysis of their problems. This is the quintessential “talk therapy” and does not focus on short-term problem-solving in the same way as CBT and behavioral therapies.

In some cases, kids benefit from individual therapy, one-on-one work with the therapist on issues they need guidance on, such as depression, social difficulties, or worry. In other cases, the right option is group therapy, where kids meet in groups of 6 to 12 to solve problems and learn new skills (such as social skills or anger management).

Family therapy can be helpful in many cases, such as when family members aren’t getting along; disagree or argue often; or when a child or teen is having behavior problems. Family therapy involves counseling sessions with some, or all, family members, helping to improve communication skills among them. Treatment focuses on problem-solving techniques and can help parents re-establish their role as authority figures.

Preparing for the First Visit

You may be concerned that your child will become upset when told of an upcoming visit with a therapist. Although this is sometimes the case, it’s essential to be honest about the session and why your child (or family) will be going. The issue will come up during the session, but it’s important for you to prepare your child for it.

Explain to young kids that this type of visit to the doctor doesn’t involve a physical exam or shots. You may also want to stress that this type of doctor talks and plays with kids and families to help them solve problems and feel better. Kids might feel reassured to learn that the therapist will be helping the parents and other family members too.

Older kids and teens may be reassured to hear that anything they say to the therapist is confidential and cannot be shared with anyone else, including parents or other doctors, without their permission — the exception is if they indicate that they’re having thoughts of suicide or otherwise hurting themselves or others.

Giving kids this kind of information before the first appointment can help set the tone, prevent your child from feeling singled out or isolated, and provide reassurance that the family will be working together on the problem.

Providing Additional Support

While your child copes with emotional issues, be there to listen and care, and offer support without judgment. Patience is critical, too, as many young children are unable to verbalize their fears and emotions.

Try to set aside some time to discuss your child’s worries or concerns. To minimize distractions, turn off the TV and let voice mail answer your phone calls. This will let your child know that he or she is your first priority.

Other ways to communicate openly and problem-solve include:

  • Talk openly and as frequently with your child as you can.
  • Show love and affection to your child, especially during troubled times.
  • Set a good example by taking care of your own physical and emotional needs.
  • Enlist the support of your partner, immediate family members, your child’s doctor, and teachers.
  • Improve communication at home by having family meetings that end with a fun activity (e.g., playing a game, making ice-cream sundaes).
  • No matter how hard it is, set limits on inappropriate or problematic behaviors. Ask the therapist for some strategies to encourage your child’s cooperation.
  • Communicate frequently with the therapist.
  • Be open to all types of feedback from your child and from the therapist.
  • Respect the relationship between your child and the therapist. If you feel threatened by it, discuss this with the therapist (it’s nothing to be embarrassed about).
  • Enjoy favorite activities or hobbies with your child.

By recognizing problems and seeking help early on, you can help your child — and your entire family — move through the tough times toward happier, healthier times ahead.

Adapted from kidshealth.org

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