Depression, Anxiety and Youth Mental Health – An Introduction. Geoffrey Ahern Senior Mental Health Clinician Eastern Health / Victorian Police Mental Health and Police (MHaP) PhD Candidate – Deakin University, Melbourne 1
“Young people today are growing up in an unprecedented toxic climate of stress and pressure.” Young Minds (www.youngminds.org.uk) January 2014. 2
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"We are men in a world where men are emotionally disabled by our masculine cultural ideals." Dr Alan Downs 4
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Blood letting, this was used particularly for men. Trepanation was used to treat migraines, epilepsy and mental illness. 7
One of the most horrific practices was the lobotomy (1936-67). It was designed to remove the persons “extra and unwanted emotions.” The patient was rendered unconscious by electric shock and the action completed in under 10 minutes with tragic consequences often. 8
How old do you think the youngest person was to receive a lobotomy in this period? One of the youngest patients was a 12-year-old boy, Howard Dully. The reason for Dully’s lobotomy? His stepmother, Lou, said Howard was defiant, daydreamed and even objected to going to bed. If this sounds terrible, it’s because it is. Walter Freeman (the father of the modern lobotomy) lobotomised 19 children under the age of 18…….the youngest was a mere four years of age! 9
The sugar coma, used in the 1940 ’s for the schizophrenic was another tragic practice designed to change the personality of the sufferer. Large doses of insulin were given to “starve” the brain of sugar and then the person was “re - awoken” with a glucose injection. If the person didn’t die they often had the desired personality change, otherwise known as a severe brain injury. 10
WHAT IS MENTAL HEALTH? “..........a state of well -being in which the individual realises his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.” World Health Organisation (2007) 11
WHA HAT I T IS A S A MEN ENTA TAL ILLNE NESS SS? “A mental illness is a diagnosable illness that affects a person’s thinking, emotional state and behaviour, and disrupts the person’s ability to work or carry out other daily activities and engage in satisfying personal relationships.” 12
PERC RCENTAGE NTAGE OF AUS USTRALIANS RALIANS aged 16 16-24 24 WITH TH A MENT NTAL L ILLNE NESS SS IN N ONE NE YEAR % MALE % FEMALE % TOTAL Any Anxiety iety 9.3 21.7 15.4 Diso sorder rder Any Depr pressi sive 4.3 8.4 6.3 Diso sorder rder Any Substance tance 15.5 9.8 12.7 Use e Diso sorder der Any y Commo mmon 22.8 30.1 26.4 Ment ntal al Disorder sorder 13
PREVALENCE OF COMMON MENTAL DISORDERS IN ANY ONE YEAR 35 30 Female Male 25 20 % 15 10 5 0 16-24 25-34 35-44 45-54 55-64 65-74 75-85 14
PREVALENCE OF MENTAL DISORDERS IN LAST 12 MONTHS: MALES 25 Anxiety Disorders Depressive Disorders 20 Substance Use Disorders 15 % 10 5 0 16-24 25-34 35-44 45-54 55-64 65-74 75-85 Age 15
ALEXITHYMIA A = Without Lexi = Words Thymia = Emotions Without words for my emotions 16
BA BARRIER ERS S TO TO HEL ELP-SE SEEK EKING • Feeling too embarrassed or shy 23% 23% • Afraid the person may think badly of them 14% 14% (Mental Health First Aid Australia, 2017). 17
AD ADOLES ESCEN ENT T DEV EVEL ELOPM PMEN ENT • Ph Physical ical develo lopmen pment: t: - Secondary sex characteristics - Ongoing brain development (ie: alcohol use). • Ps Psychol chologi ogical cal develo lopmen pment: t: - Establishing identity, autonomy, intimacy - Advanced thinking and reasoning. • Social development: pment: - Achievement (educational, sporting etc). - Becoming comfortable with sexuality 18
WHAT T ARE E THE CA CAUSES USES OF MENTAL AL ILLNESS? NESS? For many years “ expe perts ts ” have argued about the causes of mental illness Is it purely a medic ical al or organic ic conditio ition involving genetic or biological factors? For example altered levels of serotonin in the brain? 19
WHAT T ARE E THE CA CAUSES USES OF MENTAL AL ILLNESS? NESS? (cont) t) Or is it essentially a psychologi ological cal phenom nomenon? on? Do personality types effect our mental state? Or is it the way we process information (cognition) that sets us up for a Mental Illness? And what about sociolo iologic gical al influences, where things such as gender and sexuality, age, location, occupation, education and socioeconomic status have an influence on our Mental Health? 20
The answer is actually all three…….. * Biological * Psychological * Sociological Mental Illness is caused by the complex interactions between all three disciplines and this gives us what we call: BIOPSYCHOSOCIAL MODEL 21
The Biopsychosocial Model Psychological Biological Sociological 22
MAI AIN N SY SYMPTO PTOMS MS OF DE DEPR PRES ESSIO SION N • An unusually sad or irritable mood • Loss of enjoyment and interest in activities • Lack of energy and tiredness • Feeling worthless or feeling guilty when they are not really at fault • Thinking about death a lot or wishing they were dead • Difficulty concentrating or making decisions • Lack of motivation or feeling irritable • Having sleeping difficulties or, sometimes, sleeping too much • Loss of interest in food, or, sometimes, eating too much. 23
MAIN IN SYMPTO TOMS MS OF ANX NXIETY ETY 24
WHA HAT IS AN A N ANX NXIETY ETY DI DISOR ORDER DER? Everybody experiences anxiety at some time • Anxiety can vary in severity from mild uneasiness through to a • terrifying panic attack. An anxiety diso sorder der differs from normal anxiety in the following ways: • o It is more severe (than what might be considered normal) o It is long lasting (than what might be considered normal) o It has a negative impact on the person’s day to day quality of life 25
Treatment for Depression and Anxiety: The first thing to say is that we expect recovery. • The fast majority of adolescents dealing with depression • or anxiety will be perfectly fine (with some bumps along the way). According to all our peak mental health bodies in Australia, the first line of treatment is: Talking • “Addressing lifestyle is also of critical importance.” (Beyond Blue). 26
Medication? • Medication is and should always be seen as only one part of the treatment. • Ideally the young person will be talking about their mental health with a trained professional at the same time. • All people caring for the young person (school staff, counsellors, youth leaders etc) should be aware of the treatment. • The Royal Australian and New Zealand College of Psychiatrists suggest that if medication is used a comprehensive management plan should be prepared. 27
A tip for parents: “There are no quick fixes or magic bullets for recovery from a genuine mental health diagnosis.” We need to consider a creative, multi-faceted approach to facilitate a holistic recovery. 28
“We need an extended period of assessment and treatment when it comes to serious mental illness in adolescents. Just like life, serious mental illness is a bit of a ‘work in progress’ and sometimes labels can do more harm than good.” Dr Mark Cross – Adolescent Psychiatrist “Changing Minds, ABC Mental As Week 2015” 29
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ADOLE LESC SCENTS ENTS AND LONEL ELINESS INESS “Loneliness is a crucial factor in mental health problems in adolescents. In fact, our research suggests that even regular exercise doesn’t make up for the negative impact of the loneliness.” Professor Kathleen Mullen-Harris University of North Carolina 32
Can an te techn hnolo ology gy pl play ay a r a rol ole e in in con onne necti ction on? YES NO 33
Not all human inter eraction actions s are create ated d equal ally ly (at least st not biochemically) hemically) Take a bunch of happy, Subject them to some well adjusted girls aged testing in front of some 8-12 years of age stone faced academics Then split them in to 4 groups................ 34
Allowed to talk to mum Groups 1 and 2 face to face and tell her had lower about what just happened Cortisol and higher Oxytocin levels after Allowed to phone mum communicating and tell her about what with mum. just happened Allowed to text mum and Groups 3 and 4 tell her about what just had higher happened Cortisol and lower Oxytocin Not allowed to talk face to levels. face, phone or even text anyone 35
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