Posts Tagged ‘
Thursday, August 15th, 2013
Moms who have young kids have lots of sources of stress – including unavoidable rites of passage of parenthood (sleep deprivation), everyday hassles (just can’t fit in that shower), and new responsibilities on top of old ones (how exactly do you take care of everything you need to do when you have to take care of a 6-month-old?). There are countless other streams of stress – including big “macro” society conditions like the economic recession – that impinge on everyday life and influence parenting. Now, you may be thinking – and this is a reaction I frequently encounter – that if stress is inevitable, why bother discussing it?
Well, there are four reasons.
First, stress takes its toll on moms. One of the strongest predictors of depression is high levels of stress. Given that women in general are at high risk for depression – some studies suggest nearly 1 in 3 women will experience clinical depression – the additional stresses of being a mom can have serious consequences. And keep in mind that one of the reasons that depression can become such a problem is that is a recurrent condition – it tends to come back after it subsides.
Second, children of depressed parents are at very high risk for early-onset depression as well as other behavioral problems. The process can start as early as infancy, accelerate in toddlerhood, and result in increased depressive symptoms in childhood, culminating with onset of clinical depression in the teen years. Chronic stress has other negative effects on childhood development that can lead to increased risk for health problems later in life. And there is some evidence that severe stress during pregnancy can have adverse effects on fetal development and contribute to things like low birth weight.
While stress and depression are insidious and impairing, there is, without question, hope. The third reason to reflect on all this is that depression is treatable. There is no one treatment, so it’s important to give yourself enough time to find the right mix of psychotherapy and/or pharmacology (antidepressants). The reality is that you can get a handle on depression and also lessen the risk of future depressive episodes with effective treatment.
Which leads to a fourth reason to talk about stress and depression – when moms get treated successfully, their kids improve as well. There have been large-scale studies showing that these positive effects can be long lasting, and include reductions in both child symptoms and actual diagnoses of depression and other disorders in the offspring. Other more fine-grained studies have shown how child symptoms of depression “mirror” parental levels – and when parental symptoms lessen with treatment, so do their kids’ symptoms. Note that no intervention needs to be done directly with the kids to gain a benefit – the effect comes simply from successfully treating the parent.
So, moms who are under lots of stress and feel like they are depressed should become aware of the symptoms of depression - and seek out well-qualified treatment. Doing this not only helps moms, but directly improves the lives of their kids.
Depressed Woman via Shutterstock.com
Add a Comment
antidepressants, depression, Health, Kids Health, moms, Pregnancy, psychotherapy, Stress, treatment | Categories:
Behavior, Health, Intervention, Must Read, Parenting, Pregnancy, Red-Hot Parenting
Wednesday, May 29th, 2013
DSM-5 has raised lots of controversies by making changes to the way some psychiatric disorders are defined. But less controversial is flagging the importance of callous-unemotional traits in childhood as part of the diagnostic approach to Conduct Disorder.
Conduct Disorder refers to a pattern of behavior that consistently violates the rights of others. As kids reach later childhood and their early teens, the types of behaviors include what we would think about as things that would get kids in trouble: destroying property, breaking and entering, fighting, lying, stealing. While some kids may do some of these things now and then, what’s important clinically is when a lot of these behaviors cluster together and occur with some frequency.
There can be many reasons why kids behave this way. It’s clear that kids exhibiting signs of Conduct Disorder require some type of intervention. It’s a pattern of behavior which can be associated with a lot of bad outcomes – dropping out of school, eventual substance abuse, and even jail.
So why are callous-emotional traits relevant, and flagged in DSM-5? The risk for these outcomes may be especially high if a child is showing callous-unemotional traits – such as a lack of empathy, a lack of remorse, and shallow emotions. When tracked over time, youth with these traits are especially likely to show a stable pattern of antisocial behavior over time – from childhood through adulthood. Their actions may be (or become) especially aggressive and violent.
Treating kids with callous-unemotional traits is complicated. A number of behavioral strategies may be considered, as well as some forms of drug treatment (especially if they have symptoms of other disorders, such as ADHD or depression).
DSM-5 has certainly be criticized. There are many hot-button topics raised in the revision. But the inclusion of callous-unemotional traits is an example of how research findings can lead to diagnostic changes that are simply there to signal which kids may be at especially high risk for a number of bad long-term outcomes and hence require some immediate form of intervention. That’s solid information for a clinician to weigh during the evaluation process.
Doctor with checklist via Shutterstock.com
Add a Comment
ADHD, Callous-Unemotional Traits, conduct disorder, depression, DSM 5, Health, jail, Kids Health, substance abuse | Categories:
Behavior, Health, Intervention, Must Read, Parenting, Red-Hot Parenting
Wednesday, February 27th, 2013
Following a stimulating Intelligence Squared debate, we’ve been discussing genetic engineering (think of it as directly changing DNA) here at Parents.com – both in terms of using it to create a “Super Baby” and to prevent disease. As a follow-up, let’s consider the likelihood of genetic engineering being a factor in the future for a number of childhood psychiatric disorders – or more to the point, the challenges that lay ahead.
Autism Spectrum Disorder (ASD)
There would be hope that genetic engineering would be feasible in the future, as ASD is believed to be highly genetic in origin. However, the genetic basis for ASD is not clear. In fact, there may be a range of genetic etiologies. For example, some cases may be due to a rare genetic mutation – but there could be a number of mutations that can lead to ASD (not just one identified disease gene) making the idea of genetic engineering more challenging. The majority of ASD cases may reflect a complex mix of genetic and environmental influences – and the latest statistical modeling suggests that the genetic contribution to ASD may not be as strong as previously thought (and that the role of the environment may be more pronounced). For those situations, the idea of using genetic engineering is even more murky, because there may be many genes involved and they probably interact with a variety of environmental factors. All of this is not to say that genetics won’t lead to possible biological therapeutics – rather it’s to point out that the lure of genetic engineering as a solution may not be the avenue that will be pursued.
The best evidence to date suggests that ADHD is due to a mix of genetic factors along with the influence of a number of environmental factors. As discussed above, this makes the pure application of genetic engineering difficult to imagine. There may a large number of genes involved, each of which may only have a small effect on the likelihood of developing ADHD – which, simply put, would make it very difficult to know what genes to target. Again, it’s tough to predict where genetic research will go, but while it may certainly lead to improved treatments over time for ADHD, it’s tough to see the role of genetic engineering.
You’re starting to see a pattern here. Like ADHD, depression is also thought to be influenced by many genes as well as the environment. As discussed above, this constellation of risk factors does not suggest that genetic engineering will be a factor any time soon.
Conduct Disorder (CD)
This is the same deal as the case for ADHD and depression – and it may be that the environment plays an even stronger role in the etiology of CD.
The idea of genetic engineering is provocative. But the reality may be far in the future for most childhood psychiatric disorders – and in many cases it may not be the way in which genetic research gets translated into prevention and intervention.
Molecular Biology Test via Shutterstock.com
Add a Comment
ADHD, ASD, autism spectrum disorder, conduct disorder, depression, DNA, Genetic Engineering, Genetics, Health, Intelligence Squared, Kids Health | Categories:
Behavior, Genetics, Health, Intervention, Must Read, Parenting, Pregnancy, Questions, Red-Hot Parenting
Monday, October 29th, 2012
We all know that depression is very common in women, and that it can have a profound effect on parenting when a mom is affected. But even though depression affects more women than men, this doesn’t mean that it is rare for a man – and hence a dad – to get depressed. And since some of the symptoms can differ by gender, it’s worth knowing some of the signs that men might show that could signal depression.
There is a terrific feature on Yahoo! Health that provides 12 symptoms of depression in men – I strongly suggest that you click here to read it. The list includes fatigue, sleep problems, physical problems, irritability, indecision, difficulty concentrating, anger/hostility, stress, anxiety, substance abuse, sexual dysfunction, and suicidal thoughts. Below I provide a short summary and some comments.
Let’s start with what you won’t find on the list – sadness and crying. This is potentially the biggest gender difference you will find in terms of depression symptoms. Of course, not every woman who is depressed is teary or overtly sad, but it’s very common for this to be the case (especially when a woman is deep into a depressive episode). This does not seem to be the case for men. So it’s important to recognize that a man may be depressed even if he doesn’t appear to be very sad.
Some of the symptoms overlap with those you see in women. Fatigue and sleep problems can be common. Keep in mind that sleep issues can involve either not getting enough sleep, or getting too much sleep. Physical problems (aka somatic symptoms) are also common – including backaches and headaches. These are not imagined – they are truly physical symptoms. You can count sexual dysfunction in here as well.
Cognitive problems – difficulty concentrating, indecision – can also be a red flag, especially if they are observed in conjunction with other symptoms.
Problems with emotional regulation can be telling, but again not so much in terms of sadness – rather they manifest as irritability and anger/hostility. Look for changes in these negative emotions (which may signal the onset of a depressive episode). Men can also experience and report high levels of anxiety. While this is true for women as well, keep in mind that it may not be accompanied by sadness. In addition, as indicated in the Yahoo! Health feature, men may say that they are “stressed” – and sometimes this can be their way of saying “depressed” (perhaps without even knowing it).
Substance abuse can also signal depression in men. While, again, the same may be true in women, it’s important to remember that these kinds of signs in men may be there even without what you might think of as the classic signs of depression. And, of course, any report of suicidal thoughts should be taken seriously.
Every individual is different, so the main thing is to see if some of these symptoms come together at the same time (or close in time) – and if they seem to be getting worse. Remember, depression is an episodic disease, so you will see notable increases in symptoms that happen before the onset of a severe episode. Do keep in mind that each of these symptoms don’t necessarily indicate depression – rather, it’s the combination of a number of them that makes you consider depression.
There are two truisms that apply equally to men and women: depression is a disease, and effective treatments exist. So if you suspect that a man may be suffering from depression based on observing some of these symptoms, it’s important to support evaluation and treatment.
Silhouette Of Depressed Man Via Shutterstock.com
Add a Comment
Dads and depression, depression, Depression in Men, Health, Kids Health, Symptoms of Depression in Men, Yahoo! Health | Categories:
Behavior, Health, Intervention, Must Read, Parenting, Red-Hot Parenting, Relationships
Thursday, September 27th, 2012
Virtually every developmental, behavioral, and emotional disorder is assumed to have a significant genetic component. Autism, ADHD, depression, anxiety, addiction, dyslexia – you name it, DNA is believed to play a role. For decades, genetic research has sought to uncover the specific genes that contribute risk to all these disorders. While progress has been made – including lots of hints that certain genes may play some role for some disorders – the overall state of the field is that there is much that still needs to be learned about genetics and childhood disorders. The latest hope is that a new understanding of how the human genome may be achieved by a deeper understanding of how DNA really works, as described in more than two dozen papers recently published.
The research initiative called ENCODE is focused on extensive regions in DNA that were thought to be, well, junk. You may have heard that only 20% of DNA is actually doing something. Well the new research is showing that nearly 80% of DNA is doing something, and what’s really important is not just the genes that code for proteins, but also the vast number of genes that act as switches that turn other genes on and off. This regulatory function has been known for a long time, and it’s importance has always been grasped. What’s different now is that it seems to be a predominant mechanism with many genes devoted to it. And researchers believe that it may hold clues to understanding how many disorders arise from expression of genetic risk factors.
What is really changing is the emerging idea that it’s not so much what is in the “core” genes that directly code for things, but rather the complex mix of influences that turn genes on and off and hence influence development. Here’s where non-genetic influences – ranging from the prenatal environment to parenting strategies – may mechanistically link to how genes get expressed, or not.
You can anticipate sometime in the far, and probably near, future research studies that begin to explore this. There is certainly hope that embracing this increasing complexity of genetic systems will lead to more progress than we’ve seen in the past in terms of deliverables that either explain the causes of disorders or imply potential treatments. That, of course, remains to be seen, as we have heard lots of hype over the decades of how genetics will revolutionize our understanding of childhood disorders. We’ll need to take a wait and see approach to this – and continue to embrace interventions that are known to work right now for disorders, even without knowledge of genetic underpinnings. To that end, let’s hope that research portfolios continue to be diversified and not over-invest in genetic strategies that may, or may not, actually revolutionize treatment.
DNA and RNA via Shutterstock.com
Add a Comment
ADHD, autism, depression, DNA, DNA encyclopedia, dyslexia, ENCODE, genetic disorders, genomics, Health, Kids Health | Categories:
Behavior, Genetics, Health, Intervention, Red-Hot Parenting