Thursday, October 11, 2018

World Mental Health Day 2018


World Mental Health Day

World Mental Health Day is observed every year on the 10th of October to take awareness of mental health issues into the community. The theme for 2018 was Young People and Mental Health in a Changing World[1].

Pathfinder Clinic WMHD2018 Event

On World Mental Health Day 2018 Pathfinder Clinic psychologists manned a desk for the day in the atrium at Magarpatta City, Pune. They used a short mental health quiz to pique the interest of anyone entering the shopping complex and rewarded all participants with an origami patronus! They were also administered a test of their current resilience. Our psychologists engaged in over-the-counter discussions on what constituted mental health issues. People brought out their own family and interpersonal problems, and to many it was an eye-opener that mental health issues could be contributory.

Why focus on young people?

Young people don't vote. They often don't have a voice and depend upon others to champion their right to health justice. The growing prevalence of youth mental health problems is a tsunami, and parents, the community and governments float in a small boat, named “denial”, on the quiet sea[2]. Most mood and anxiety disorders, and schizophrenia have their onset in this age group[3]. Investing in early intervention programs is not only beneficial for patients, but also cost-effective[4].

What is changing in the young persons world?

The increasing use of online technologies and growing connectivity to virtual networks through the day and night add to pressures faced by adolescents. It is unclear whether some of these changes affect normal aspects of human behavior and cause psychiatric disorders. At the other end of the spectrum are young people caught in humanitarian crises due to conflict and environmental disasters that can overwhelm the coping ability of the individual.

Building resilience in young people

Resilience in young people is determined by their personal and social resources. Engaging young persons in therapy builds resilience through processes of bouncing back and personal growth[5]. Resilience is also built through the process of enhancing immunity to stress by 'innoculation', especially if the prior stress occurs early in life, is mild in its magnitude, and is controllable by the individual[6].

References

  1. WHO. World Mental Health Day 2018. Accessed 2018-11-03
  2. Helen Christensen, 1 Charles F. Reynolds, 3rd, 2 and Pim Cuijpers. Protecting youth mental health, protecting our future. World Psychiatry. 2017 Oct; 16(3): 327–328. Published online 2017 Sep 21. doi: [10.1002/wps.20437]. Accessed 2018-11-03
  3. Cornelius LR, van der Klink JJ, de Boer MR, Brouwer S, Groothoff JW. High prevalence of early onset mental disorders among long-term disability claimants. Disabil Rehabil. 2016;38(6):520-7. doi: 10.3109/09638288.2015.1046566. Epub 2015 May 14. Accessed 2018-11-05
  4. Celso Arango. First-Episode Psychosis Research: Time to Move Forward (by Looking Backwards). Schizophr Bull. 2015 Nov; 41(6): 1205–1206. Published online 2015 Sep 20. doi: [10.1093/schbul/sbv126]. Accessed 2018-11-05
  5. Ayed N, Toner S, Priebe S. Psychol Psychother. Conceptualizing resilience in adult mental health literature: A systematic reviewand narrative synthesis. 2018 Jun 11. doi: 10.1111/papt.12185. [Epub ahead of print]. Accessed 2018-11-16.
  6. Ashokan A, Sivasubramanian M, Mitra R. Seeding Stress Resilience through Inoculation. Neural Plast. 2016;2016:4928081. doi: 10.1155/2016/4928081. Epub 2016 Jan 5. Accessed 2018-11-16.

Tuesday, October 9, 2018

Parenting an Adolescent

parents and adolescent children silhouetted against water and sky
Adolescence is a time of transition. Most parents find themselves bewildered by the changes in their previously affectionate and obedient children. Mood changes, withdrawal, monosyllabic answers and arguments find most parents asking, “What have we done wrong?”

Adolescence is marked by profound changes brought about by the hormonal surge at puberty. The physical changes are accompanied by emotional, behavioural and intellectual changes to which the child has to adapt rapidly.
“As their bodies, brains and worlds rearrange themselves, you (parents) will need to do your own reshuffling.”

Changing role of parenting adolescents

The need for autonomy, independence and a search for one’s own unique identity is an essential part of adolescence. Often, this is achieved by questioning and testing existing rules and norms. Make space for this quest. Handle an occasional error of judgement with explanations rather than with accusations and confrontation.

The essentials of parenting at this age are
  1. Trust
  2. Empathy
  3. Respect
  4. Support
Trust is important in all relationships. Trust your teen to do what is right. As far as possible, avoid correcting them and pointing out mistakes. Allow them to learn on their own.

Empathise. Your adolescent child is often plagued by self-doubts and insecurities. Remember you were an adolescent once, and do not trivialise their problems.

Respect their need to be away from you, alone or with friends. Listen to their opinions and try not to be dismissive of their views and values.

Support. Assure them of your love and support without being intrusive; this will encourage them to come to you in need.

Parenting styles

An authoritative parenting style provides the adolescent with opportunities to become self-reliant within a set of rules, limits and guidelines appropriate for his/her developmental age. The personality and temperament of the child may also influence your parenting style (a co-operative and responsible teen requiring much less supervision). The environment (e.g an unsafe neighbourhood) can also dictate your parenting style. Privileges and limits may be set with the active participation of the child. It helps to state your expectations without ambiguity (what is acceptable behaviour and what is not), set clear limits and enforce consequences (loss of privileges) when limits are not adhered to.

When parents differ in their parenting styles.

One parent (often a father who is away a great deal) may tend to be permissive in his parenting. Adolescents (and children!) are quick to take advantage of differences between parents. It is important for the parents to arrive at a consensus privately and present a united front when dealing with limits and consequences.

Autonomy vs Monitoring

There are no hard and fast rules. Monitoring does not mean constant surveillance. Safety concerns entail knowing about the whereabouts of the adolescent outside school hours, friends they are with and contact information. A schedule to return home should be worked out. Similar limits should be set for time spent on social media. Be honest in communicating your concerns and avoid doing things behind their backs. It only leads to lack of trust and a tendency to conceal things from you.

Do not seek to control. Often, clashes between parents and adolescent children are about who has control. Adolescents struggle for control over what they feel is their own life, while parents struggle to hold onto the control they had earlier.

Peers

Sometimes, you may be uncomfortable with the company your adolescent keeps. Do not rush into judgements and accusations. Observe for yourself if there is a genuine cause for concern. Teach your adolescents to say ‘no’ to what they feel uncomfortable about. Explain the harmful effects of risky behaviour (alcohol, drugs, sexual activity) at a young age.

When to seek help

Repetitive problem behaviours and high-risk behaviours require professional help and guidance. Aggressive and violent behaviour, progressive academic deterioration, school refusal or truancy, lying or cheating demand immediate attention. Increasing moodiness, lack of communication, inattention to personal hygiene are other warning signs of psychological distress.