Tuesday, October 15th, 2013
Parents whose children face serious or life-threatening illnesses are likely to experience symptoms of post-traumatic stress, including anxiety and depression. These symptoms may, in effect, extend the traumatic effect the illness has on the whole family because it affects how parents treat siblings, their spouses, and other relatives. More on a new study about post-traumatic stress in kids and adults after a child’s injury from The New York Times:
Researchers who study parental stress tend to reach for the oxygen-mask metaphor: if you don’t breathe yourself, you aren’t going to be able to take care of your child.
“Parents need to feel well enough that they can then be there for their child, their other children,” said Nancy Kassam-Adams, a psychologist who is the director of the Center for Pediatric Traumatic Stress at Children’s Hospital of Philadelphia. “The hardest thing is self-care.”
Dr. Kassam-Adams is the lead author of a new review of post-traumatic stress in both children and parents after the children were injured, which concludes that about one in every six children, and a similar percentage of parents, experience significant, persistent symptoms. They may have intrusive and distressing memories and dreams, or continue to avoid people or places that evoke the circumstances of the injury, or struggle with mood problems, including depression. If untreated, this can damage the child’s emotional and physical recovery.
Research into the effects of parental stress developed as pediatric cancer treatment claimed more and more success stories, medical victories that gave children their lives back. Clinicians and social workers — and parents themselves — began asking questions about how to help families continue on with those triumphantly recovered childhoods.
It helped, in part, to tell parents that they’d been enlisted in a war, said Anne E. Kazak, a pediatric psychologist and co-director of the Center for Healthcare Delivery Science at Nemours Pediatric Health System in Wilmington, Del. Parents connected to this metaphor: “You’ve been part of the war on cancer, the battle fighting it,” she said.
Some of the strategies and insights gained from this body of research are already visible in most children’s hospitals: a place for parents to sleep, even in the intensive care unit; including parents in so-called family-centered rounds; a staff attuned to interpret a parent’s extreme behavior as a cry for help, rather than a source of irritation and extra work.
But what happens after children are out of the medical danger zone? Many parents continue to experience the physical symptoms of stress — the racing pulse, the dry mouth. They continue to flash back to the moment of the cancer diagnosis, the moment of the very premature birth, the moment of the accident.
“It’s my belief a parent who’s traumatized is always expecting the other shoe to drop, will always be scanning the horizon,” said Dr. Richard J. Shaw, a professor of psychiatry at Stanford.
Image: Mother holding infant’s hand, via Shutterstock
Add a Comment
Wednesday, October 9th, 2013
Kevin Breel, at age 19, has given a TED talk in which he’s painfully honest about living with depression as a teenager, and feeling that stigmas that surround mental health were stopping him from asking for help. More from Today.com:
Like many of the 121 million people worldwide who suffer from depression, Breel said he was leading a double life. In high school, while everyone else saw a happy popular kid and star on the basketball court, deep inside there was a boy tortured by intense pain that kept ratcheting up.
“I’d look at the school,” Breel told Geist. “And I would know in my head that, ‘I’m about to walk in there and smile, laugh, high-five people, and put on a total front.’”
If you haven’t been depressed, there’s no way to understand it.
“Real depression isn’t being sad when something in your life goes wrong,” Breel says. “Real depression is being sad when everything in your life is going right.”
“I felt like I couldn’t be happy,” Breel added.
He believes his depression was triggered by the tragic loss of a best friend coupled with the divorce of his parents, and he turned his feelings of loss and anger inward.
“I started to, in a way, hate myself,” he said. “I felt so unhappy and I couldn’t explain why or justify why to anyone. So I didn’t feel like I could talk about it.”
As a teenager he used sports as a way to escape his pain. But his successes, instead of making him feel good, only underscored how bad he felt.
“We had just won a high school basketball championship, and I was leading scorer of the tournament,” Breel said. “I was first team all-star, and our team won the championship. I had everything that I had thought of for four years. And I realized that that wasn’t going to take away my pain.”
See Breel’s whole TED talk here:
Add a Comment
Monday, September 30th, 2013
New moms are increasingly shortening their maternity leaves, citing financial and personal pressures as reasons for going back to work within weeks of giving birth. Analysis of data from the National Center for Health Statistics shows that as many as half of new mothers are shortening their leaves by half. More from Today.com:
About two-thirds of U.S. women are employed during pregnancy and about 70 percent of them report taking some time off, according to most recent figures from the National Center for Health Statistics. The average maternity leave in the U.S. is about 10 weeks, but about half of new moms took at least five weeks, with about a quarter taking nine weeks or more, figures showed.
But a closer look shows that 16 percent of new moms took only one to four weeks away from work after the birth of a child — and 33 percent took no formal time off at all, returning to job duty almost immediately.
That means more women are coping with pregnancy-weary bodies, the demands of a newborn and the demands of a boss — all before the “Welcome, Baby” flowers have wilted on the bedside table.
Research has shown that shorter leaves can interfere with recommended breastfeeding duration and may contribute to higher rates of depression among new moms.
Image: Working mom, via Shutterstock
Add a Comment
Friday, September 13th, 2013
Group therapy sessions may prevent episodes of depression in at-risk teens, especially those whose parents are also depressed, according to a new study conducted at Boston Children’s Hospital. Reuters has more:
“What was exciting was the sustained effect over the length of the follow-up,” said lead author Dr. William R. Beardslee of the psychiatry department at Boston Children’s Hospital.
He and his coauthors had previously found a reduced risk of depression nine months after the cognitive behavioral therapy sessions began. The new results show that risk was still reduced two years after they ended.
The study included 316 teenagers of parents with current or past depressive disorders.
Half were assigned to the therapy program, which involved eight weekly 90-minute group sessions with a trained therapist followed by six monthly sessions, and the other half received standard care. The kids had symptoms of depression, but not diagnosable depressive disorders.
The researchers tracked teens’ “depressive episodes” lasting at least two weeks, as reported by the kids and their parents.
During the study and the two-year follow-up period – a total of 33 months – 37 percent of kids assigned to the therapy sessions had at least one depressive episode, versus 48 percent of those in the comparison group.
But that difference was only seen among teens whose parents were not clinically depressed when the study began.
When parents were not depressed at the time of the study, cognitive behavioral therapy prevented one depressive episode for every six kids in the program, the researchers found. However, for kids with currently depressed parents, therapy sessions didn’t seem to have an effect, they wrote in JAMA Psychiatry.
“First, we need to understand how current parental depression is related to differential outcomes,” Beardslee told Reuters Health. “Then, we need to target these factors to reduce their effects on child outcome.”
Image: Teens talking, via Shutterstock
Add a Comment
Tuesday, July 23rd, 2013
Women who get poor sleep during pregnancy–either not enough time asleep or restless sleep–may disrupt the immune system and lead to lower birth weight and other complications, a new study published in the journal Psychosomatic Medicine has found. More from ScienceDaily.com:
Women with depression also are more likely than non-depressed women to suffer from disturbed sleep and to experience immune system disruption and adverse pregnancy outcomes.
“Our results highlight the importance of identifying sleep problems in early pregnancy, especially in women experiencing depression, since sleep is a modifiable behavior,” said Michele Okun, Ph.D., assistant professor of psychiatry at Pitt’s School of Medicine and lead author of the report. “The earlier that sleep problems are identified, the sooner physicians can work with pregnant women to implement solutions.”
Adequate and high-quality sleep, both in pregnant and non-pregnant women as well as men, is essential for a healthy immune system. Pregnancy often is associated with changes in sleep patterns, including shortened sleep, insomnia symptoms and poor sleep quality. These disturbances can exacerbate the body’s inflammatory responses and cause an overproduction of cytokines, which act as signal molecules that communicate among immune cells.
“There is a dynamic relationship between sleep and immunity, and this study is the first to examine this relationship during pregnancy as opposed to postpartum,” added Dr. Okun.
While cytokines are important for numerous pregnancy-related processes, excess cytokines can attack and destroy healthy cells and cause destruction of tissue in pregnant women, thereby inhibiting the ability to ward off disease. For expectant mothers, excess cytokines also can disrupt spinal arteries leading to the placenta, cause vascular disease, lead to depression and cause pre-term birth.
Image: Sleeping pregnant woman, via Shutterstock
Add a Comment