Exploring ten myths and facts regarding child mental illness origins and treatment
Prior to the Covid-19 pandemic, research studies documented an alarming rise in child and youth mental illness. The long-term effects of imposed isolation of families and removal of family support networks are largely unknown, but early reports during the Covid-19 pandemic indicate an alarming escalation in child/youth mental illness. Historically, empirical evidence regarding the origins of psychiatric disorders has taken a back seat to industry-driven pharmaceutical studies e.g. the cure preceded the cause, with an alarming rise in use of psychotropic medications for children with problematic behaviors. Presently we are witness to an escalation in the use of screen-based devices (in homes and schools) with consequences threatening both their physical and mental health. Children are increasingly sedentary, isolated, overstimulated and often neglected resulting in problematic behaviors which again, can present as mental illness. A lack of pragmatic and thorough research surrounding mental illness has significantly muddied the waters, often confusing and further misdirecting child mental illness diagnosis and treatment. As mental illness soars in children and youth, the salient question needing an answer is “What are ALL the factors contributing to child mental illness?” This article explores common myths and known (but often understated) facts regarding mental illness, and could assist parents, health and education professionals in preparation for the upcoming onslaught of child and youth mental illness.
While heavily funded and pervasively researched, to date there are no identified genes for mental illness, but rather what are termed “candidate genes” or genes thought to be implicated in different mental health disorders. While ‘genetic predisposition’ is a term still widely referenced by health professionals, it is often confused with the term ‘familial’ or ‘runs in the family’. An interesting area of study is in the field of epigenetics where environmental factors or normal developmental changes affect gene activity and expression. Epigenetic theory precludes finding “the gene” for mental illness, as human genes apparently can change to some degree in relation to their environment. “The roles of the environment and learning behavior in the ultimate expression of genetically predisposed individuals are, however, undisputed” (encyclopedia.com). While it is likely that genetics plays a role in mental illness, funnelling the majority of research funding toward this area is unwise.
Also undisputed in the research literature is mental illness in the surrounding family and subsequent impact on the mental health of its progeny. Children of parents with mental illness have much higher incidence rates of mental illness than children of healthy parents. Children growing up in a household with parents or siblings who have psychiatric disorders has significant negative impact on attachment formation between parent and child (see 6. Attachment). Parents with mental illness may have been exposed themselves to abuse, neglect or trauma. You can’t do what you don’t know, and parents who have not known functional parenting require support and guidance. Parents with dysfunctional social and emotional modelling can introduce other destructive variables such as unpredictability and stress for the child, increasing risk of child mental illness. Including families in health and education team meetings is essential for achieving best outcomes for children with difficult behaviors.
As much as parents and educators would like to believe, normal childhood and child problematic behavior is not a diagnosis. When children are neglected, abused or exposed to trauma, their behavior is a mirror to the inner pain and struggle they are experiencing. Problematic behavior is a mode of communication, and if we don’t listen, the behavior escalates. As a pediatric Occupational Therapist, I am frequently referred to what I term the “sad/mad/bad” children who typically present with problematic behaviors which are associated with mental illness. Early years are marked by sadness exhibited by despondence, vacant stares, and failure to thrive. Unchecked sadness often manifests at the toddler stage as being mad or angry with hitting, biting, and pinching others. By school age entry, this little human being has learned that being bad (punching, kicking, swearing) is about the only way they can get noticed and get their needs met. Sad/mad/bad children are crying for help, not for a mental illness diagnosis and certainly not for medication.
As stated previously, the development of psychotropic medications (anti-depressants, anti-anxiety, sedatives, stimulants, anti-psychotics) preceded establishing the origins of mental illness and is based on the “chemistry imbalance myth” which is still perpetrated by many education and health professionals. The brain is a bath of neurochemicals called transmitters which allow communication between nerve cells and is designed for homeostasis or balance. A person’s brain chemistry is changed by everything that influences him or her, whether internally or externally. When given exogenous chemicals such as an anti-depressant, the brain up or down regulates its own production of neurotransmitters to adjust to these foreign invaders resulting in a “neurotransmitter flood” with severe behavioural results (see 10 min. video by CCHR “Drugging Children”). While a child’s symptoms may in the short-term appear improved, long-term drug side effects are common and often are worse than the initial diagnosed symptoms. Acting out (violence) and suicide (acting in) are two of the most common psychotropic medication side effects which are more pronounced when prescribed for children in the early years; often these behavioral side effects are then further medicated. A travesty in the medical system is the lack of qualified psychologists and psychiatrists to adequately treat children with mental illness, leaving the less qualified family physician to diagnose and prescribe medications. While the discovery of certain neurotransmitters and their roles in mental disorders has led in turn to the discovery of seemingly effective medications to treat these disorders, it has also resulted in the unfortunate notion that medication is the only method of treatment that is helpful. We can stop this pervasive drugging of children with psychotropic medication by trial of other options (screen reduction, family support, increased access to healthy activities etc.).
Medical conditions such as brain tumors, overuse or improper use of drugs or alcohol, or traumatic injuries to the brain can result in damage to brain structure and function causing abnormal behaviors, Organic reasons for child problematic behaviour and/or mental illness must be considered and medically investigated prior to mental health diagnosis by requiring involvement of medical professionals on the child’s team.
Stress activates the sympathetic nervous system causing the release of adrenalin and a flight, fight or fright (freeze) reaction. External stressors can be events (neglect, abuse, trauma) which activate the sympathetic response, whereas internal stressors can be thoughts, feelings or perceptions about those events. The interplay of these two forms of stress affects brain chemistry just as it can affect physical health, resulting in aberrant behaviours that can present as mental illness.
Overuse of screen-based technologies is the greatest threat ever known to humankind. The ways in which we are raising and educating children with technology are not sustainable. What may appear to be anxiety, depression, ADHD or autism, may be early screen dependence or even screen addiction. Prior to mental health diagnosis and psychotropic medication prescription, children must have a screen media reduction intervention. Without this crucial step, well meaning health and education professionals have no idea what they are diagnosing and treating. For further information please read author’s published article “Unplug – Don’t Drug – A critical look at the influence of technology on child behavior with an alternative way of responding other than evaluation and drugging”.
The salient underlying causal factor for child mental illness lies in the quality of attachment between primary parent/caregiver and child. Consistent nurturing and love from caregivers combined with structure, routines and rules, creates predictability and security and helps children learn to self-regulate their emotions. The relationship between parents and how those parents treat and raise their children, contributes to the formation of each child’s own sense of self. Early relationships are a ‘social template’ which children use as a map for all future relationships. Self-regulation and social ability are two important components for eventual success as an adult. Primary attachment between parent and child can be malformed or disrupted through neglect, abuse or trauma. Early onset, intense, or prolonged neglect, abuse or trauma by a parent can create a world for children which may include chaos and unpredictability. Unstable and violent environments can result in children feeling insecure, lonely, depressed, angry or anxious. Children who struggle with these feelings often exhibit a variety of problematic behaviors which may be mistakenly diagnosed as mental illness. For more information on attachment watch the 5 min. video “The role of attachment in infancy on later mental and physical health outcomes”.
As parents and educators become more and more addicted to screen media and devices, children are increasingly being neglected. In the absence of an attentive parent, children are forming unhealthy attachments and addictions to screens which again, can present as problematic behaviours and/or mental illness. Never before in the history of humankind, have we witnessed children with addictions. It is imperative that prior to any mental illness diagnosis or prescription of psychotropic medications, health and education professionals must perform a screen use inventory to determine screen media content and duration of use.
- Sense of Purpose
Humans are ‘pack animals’ and consequently don’t survive outside the ‘family pack’. Children flourish when they think they are integral members of their family pack and have a sense of duty or purpose. Consider a farming family 100 years ago where each child had multiple, scheduled chores which if they failed to complete in a timely manner, might result in death. This sense of purpose and routine are integral traits toward building self-worth and core values needed to become a successful worker in the future. Purpose and values are modelled by parents, but also achieved through scheduled chores. As we move toward this child mental health crisis, keeping in mind that we need to help children identify and engage in productive activities (chores, jobs) as mental health protective measures. Children who have a sense of purpose and self-worth are much less likely to engage in problematic behaviours.
Despite vast research supporting a variety of successful treatments for mental illness, many parents report that they were told by their medical professional that there is no “cure” for their child’s mental illness, and that their child will need to take psychotropic medication “for life”. While some parent report relief that finally their child has been given a diagnosis, there is a futility in being told there is nothing they can do to help their child relieve his/her suffering. If indeed primary attachment between parent and child is a salient component of child mental illness, then efforts to improve this important relationship should be front line and supported by all. Putting the cell phone down and picking up or paying attention to children is a great first step toward extinguishing mental illness. While Covid-19 has wreaked devastation on many struggling families, this pandemic has also offered families a starting point toward a different and better tomorrow. The Great Realization by Tom Foolery is a wonderful 4 min. video poem offering a new perspective of “wit and wonder”.
No one factor can be said to be the sole cause of mental illness; rather, mental health disorders result from a complex set of forces that act upon each person as an individual. Finding the various elements that contributed to the onset of an illness requires a team effort between the child, parents and health and education professionals. Identifying all factors, if possible, provides the best road map for the healing process.
Cris Rowan is a biologist, occupational therapist, international speaker and author of “Virtual Child – The terrifying truth about what technology is doing to children”. For additional information please visit her website at www.zonein.ca or blog at www.movingtolearn.ca. Cris can be reached at firstname.lastname@example.org.