Tuesday, May 5, 2020

Caring for Children during Covid-19 | Parent and Caregiver Guide



Covid-19 has changed the way children play, learn, and live. Children may become clingy, withdrawn, angry, or start bedwetting. What can parents do to help them cope?

Respond to them supportively and listen to their concerns. Give them plenty of love and attention. Make extra time with them and remember to listen. Speak kindly and reassure them.  Make opportunities to relax and play. 

Keep children in touch with their teachers, friends, and extended family. If hospitalization occurs ensure contact by phone or video. Reassure them. 

Regular routines and schedules are required. Create new routines for learning, playing, relaxing and sleeping. Parents of younger children can implement a reward system to help kids stick with their new routine. Praise them whenever possible when they are doing the right thing. 

Provide facts about what has happened and explain what is going on. Give clear information about what to do to stay safe in words they can understand.

Provide information about what could happen in a reassuring way. Let them know they or a family member may start not feeling well. They may have to go to the hospital for some time so doctors can help them feel better. 

Parents must take care of themselves. It is OK to seek support from friends and adult family members away from their children so they can speak freely. Children will react to parental cues about how to respond, both emotionally and behaviourally. 

The red flags are the same. Suicidal ideation, self-harm behaviours, violent acting out, or a big change in normal functioning need urgent assessment. 

Stay safe, and reach out

Friday, March 6, 2020

Schizophrenia—Evolution of Humanness

brain diagram showing distortions in language and perception
Is schizophrenia bound to human evolution? Schizophrenia is a neuro-developmental disorder characterised by delusions, hallucinations, and bizarre behaviours. No other animal displays these symptoms. Depression, addiction, anxiety are all found in other animal species, but not schizophrenia. Schizophrenia is not even found in chimpanzees our most recent evolutionary ancestors. It is inheritable, and highly disadvantageous to survival of the affected person. Given this, schizophrenia should be almost non-existent. Yet it continues to affect a massive 1% of the global population. Something is pushing for the persistence of this disorder and its spontaneous manifestation in humans.

Human evolution separated from the chimpanzees 5.5 million years ago when we walked upright and then acquired language abilities. Language ability developed after 'lateralisation', the separation of brain functions into the left (sequential) and right (parallel processing) hemispheres. The peculiar delusions and hallucinations of schizophrenia can be understood as failure of the complex brain mechanism that enables the speaker to distinguish his thoughts from his speech or that of others. This brain mechanism evolved with lateralisation of brain functions. Loss of brain laterality in schizophrenia has been demonstrated.

Comparison of the gene sequences of early humans and their close evolutionary relatives, the Neanderthals have shown that regions of the human genome that underwent positive selection are enriched by association with schizophrenia. This suggests that schizophrenia susceptibility factors may be a "side effect" of human achievements like language and creative thinking. 

Recent evolutionary modifications in brain wiring and connections may have played a role in the development of schizophrenia in humans. Compared to our closest living relative the chimpanzee, brain connections present only in humans show a higher involvement in schizophrenia. Evolutionary changes in the human brain related to supporting more complex brain functions are paralleled with a higher risk for brain dysfunctions that can manifest as schizophrenia.

However, this genetic susceptibility is actually reducing. A study comparing modern-human-specific gene sites with archaic ones has shown that schizophrenia-risk related genes in modern humans are much less than those in Neanderthals and Denisovans (archaic humans). So negative selection of schizophrenia risk-related genes are probably being gradually removed from the modern human genome.

References

  1. https://en.wikipedia.org/wiki/Human_evolution
  2. Crow TJ. Is schizophrenia the price that Homo sapiens pays for language? Schizophr Res. 1997;28(2-3):127–141. doi:10.1016/s0920-9964(97)00110-2
  3. Crow TJ. Schizophrenia as the price that homo sapiens pays for language: a resolution of the central paradox in the origin of the species. Brain Res Brain Res Rev. 2000;31(2-3):118–129. doi:10.1016/s0165-0173(99)00029-6
  4. Srinivasan S, Bettella F, Mattingsdal M, et al. Genetic Markers of Human Evolution Are Enriched in Schizophrenia. Biol Psychiatry. 2016;80(4):284–292. doi:10.1016/j.biopsych.2015.10.009
  5. van den Heuvel MP, Scholtens LH, de Lange SC, et al. Evolutionary modifications in human brain connectivity associated with schizophrenia. Brain. 2019;142(12):3991–4002. doi:10.1093/brain/awz330
  6. Liu C, Everall I, Pantelis C, Bousman C. Interrogating the Evolutionary Paradox of Schizophrenia: A Novel Framework and Evidence Supporting Recent Negative Selection of Schizophrenia Risk Alleles. Front Genet. 2019;10:389. Published 2019 Apr 30. doi:10.3389/fgene.2019.00389

Wednesday, January 29, 2020

Creativity

How do we define creativity?

Creativity is the ability of individuals to develop novel and useful products. Novelty, originality, innovation, ingenuity are some of the words often used to define creativity. But originality is just one component of creativity. There is another essential aspect of creativity – the idea should be effective, useful or productive. 

Creativity exists in many domains and is not just limited to the arts, as most people seem to think. Creativity is at work behind most scientific inventions, innovative gadgets, health technologies and economic theories which have changed the world.

Individuals differ in their propensity and capacity to be creative. Many of us are creative in small ways - in ways we find solutions to problems of everyday life. Only a few are highly creative and leave their mark on the world.

What does it take to be creative?

Creative individuals tend to possess some qualities or traits that may contribute to or are associated with their original thinking:
  • Excellence: creative people are usually masters in their particular domains.
  • Interests: they tend to be interested and curious about many things outside their main subject. This probably enables them to combine ideas or techniques from other disciplines in unusual ways to come up with novel, workable solutions to problems.
  • Exploratory: They tend to be open to new experiences, ideas and ways of doing things.
  • Motivation: most creative individuals are passionate about their interests and internally motivated.
Creativity is not about sitting and waiting for a sudden flash of insight or inspiration. This insight usually comes after much time spent in gaining knowledge and working hard at the task on hand. Discipline and perseverance are an essential part of the creative process.

As Edison famously said
Genius is 1% inspiration and 99% perspiration
High intelligence does not equate with creativity, however, creative people tend to have an above average IQ.

Can creativity be taught?

The generally accepted view is that creativity is not a set of skills which can be taught or learnt. However, certain habits, tools or strategies can be taught, and an environment that encourages and fosters creativity can be provided in our homes, schools and workplaces.
  • Building basic skills and domain-specific knowledge
  • Stimulating and rewarding curiosity and exploration
  • Encouraging internal motivation, mastery and self-competition
  • Providing opportunities and resources
  • Promoting a willingness to take risks

Creativity and mental health

Those in creative, artistic professions tend to have a higher than average correlation with mental illnesses including schizophrenia, bipolar illness, substance abuse and suicide risk. 

Conversely, creative activities such as music, dance, art, journaling and poetry writing have been known to promote psychological well-being.

Does treatment of mental illness reduce creativity?

Treatment of mental illness could both help or hurt creativity. When treatment reduces fearfulness and avoidance it helps creativity. When it reduces motivation and flexibility it can hurt creativity. In practice there is usually a delicate balance that needs to be monitored. Some treatments are more effective at preserving creativity than others. Treatment that preserves goal-driven motivation helps all people, not only those in the arts field. As with most other aspect of health, physical exercise and adequate sleep help creativity.

Creativity is not all good nor all beneficial to society. A quick survey of the daily newspaper is enough to demonstrate how people resort to extremely creative ways to cheat, defraud or harm others.

References

  1. Flaherty AW. Brain illness and creativity: mechanisms and treatment risks. Can J Psychiatry. 2011;56(3):132–143. doi:10.1177/070674371105600303
  2. MacCabe JH, Sariaslan A, Almqvist C, Lichtenstein P, Larsson H, Kyaga S. Artistic creativity and risk for schizophrenia, bipolar disorder and unipolar depression: a Swedish population-based case-control study and sib-pair analysis. Br J Psychiatry. 2018;212(6):370–376. doi:10.1192/bjp.2018.23

Image

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