Fighting the Out-of-Work Blues

The starting bell in the employment race has always rung in the fall. September has traditionally been the best time to look for a new job. Children start a new school year, freeing parents from daytime childcare duties. Collegiates return to college campuses, leaving stores hunting for replacements. Corporations assess staffing needs as they ramp up new marketing programs. Whether looking for full- or part-time work, most job seekers found success during fall recruitment drives. But that was before the recession and double-digit unemployment.

Today, job searches are taking months instead of weeks. Layoffs have made competition fierce, forcing more and better qualified applicants into the job pool. As job searches lengthen and savings dwindle, anxiety and feelings of desperation set in. Some people frustrated with their inability to find a job that will support them or their family give up and sink into depression.

But the burden is felt not just by job seekers. When layoffs occur, those left on the job often suffer survivor guilt. Those still employed are forced to take on greater work loads, work longer hours and assume greater responsibility, further increasing stress and anxiety. For some, the stress becomes too great. According to the U.S. Labor Department, 251 people committed suicide on the job last year, an increase of 28% over the previous year and the highest number since reporting began.

Losing your job doesn’t have to be a career death knell or plunge you into a pit of despair. Traumatic experiences can be a catalyst for positive change. Psychiatric counseling that focuses on cognitive-behavioral therapy can help you find the silver lining in a layoff or difficult job search. Losing a job can be the impetus you need to abandon a career you don’t enjoy, start a business or go back to school. It can be an opportunity to explore new interests, discover what is most important to you and reinvent yourself in a new career. If you are struggling with a job layoff or searching for a new direction in your life, or if you are feeling depressed and anxious about your job, cognitive-behavioral therapy under the direction of an experienced psychiatrist like Dr. Tracey Marks can provide the support and skills you need to meet life’s challenges successfully.

What Parents Can Do About Bullying

Children who are bullied suffer higher rates of anxiety, depression and low self-esteem and are more likely to have suicidal thoughts than kids who aren’t victimized by classroom bullies, warns a recent Mayo Clinic report (see our August 21, 2009 post). With nearly half of all school-aged children subjected to bullying at some point during their school years, parents need to know how to deal with this ever-growing threat to their children’s physical and emotional health. The American Academy of Pediatrics, which now urges physicians to include signs of bullying in patient assessments, recommends that parents take the following steps to protect their children from bullying:

If your child is the victim of bullying:

• Teach your child to stand up for himself by saying things like “I don’t like what you are doing.” Teach him to stay calm and walk away from bullies.
• Tell your child when and how to ask for help. Suggest they find an adult and tell them about the problem if they are being bullied.
• Encourage your child to develop friendships with other children. Children who are socially isolated are more apt to be bullied.
• Support activities that interest your child.
• Alert school officials and teachers if your child complains about bullying. Be an advocate for your child and see that the situation is resolved.
• Ask other adults to watch out for your child’s safety when you cannot be present.

If your child is a bully:

• Emphasize to your child that you are firmly against bullying.
• Be a positive role model for your child. Show him how to get what he wants without teasing, threatening or hurting another person.
• Set firm and consistent limits on aggressive behavior.
• Be clear in defining age-appropriate consequences for bullying behavior and be consistent in implementing those consequences.
• Use effective, nonphysical discipline such as loss of privileges.
• Work with school officials, teachers, counselors and the parents of victims to develop practical solutions.

Bullying can have a disastrous long-term impact on a child’s emotional development. If your child is a bully or a victim, consider taking him or her to a board certified psychiatrist like Dr. Tracey Marks. Cognitive-behavioral therapy is effective in replacing detrimental, maladjusted behaviors with positive, life-affirming ones.

What Parents Need to Know About Bullying

Bullies. Every classroom seems to have one. In another age, bullying was considered a rite of passage; but that was before the massacres at Columbine and Virginia Tech. We now know that bullying can have long-lasting effects, both for bullies and their victims. Since April, at least three children have committed suicide as the result of bullying, according to news reports.

“Children who are bullied have higher rates of depression, anxiety, low self-esteem and other mental health conditions. Children who are bullied are more likely to think about suicide, and some of these wounds may linger into adulthood,” warns the Mayo Clinic in a recent online report.

Almost half of all schoolchildren are bullied at some point, according to the American Academy of Child & Adolescent Psychiatry. Bullying can happen to any child, but young children and those with few friends are the most at risk. Bullying need not be physical (punching, hitting, kicking or destruction of property); teasing, name-calling, racial slurs, gossip, malicious rumors, and other verbal abuse can be even more damaging. Internet and cell phone access has moved bullying out of the school yard and onto the Internet. Called cyberbullying, electronic harassment makes it easy for children to malign, embarrass or threaten their peers anonymously.

As the school year starts, it’s important for parents to tune in to their children and watch for the warning signs of bullying:

• Bruises, scrapes or other injuries
• Ripped or missing clothing or personal possessions
• Few friends or statements such as “nobody likes me”
• Headaches, stomachaches or other physical complaints
• Trouble eating
• Trouble sleeping or nightmares
• Anxiety when preparing for school or talking about school
• Fear of going to school or playing hooky
• Trouble concentrating on schoolwork; declining or failing grades
• Fighting or behavioral problems
• Depression, listlessness
• Suicidal statements such as “you’d be better off without me”

With the advent of cyberbullying through emails, instant messaging, Facebook and blogs, bullying has become so prevalent that the American Academy of Pediatrics is urging pediatricians to include signs of bullying in patient assessments. Referral to a board-certified psychiatrist with an expertise in cognitive-behavioral therapy may be required to prevent the harmful effects of bullying or treat anxiety/depression caused by bullying.

Next time: What parents can do about bullying

What’s Love Got to Do With It? Everything!

Love is the force that binds us, one to another. A husband’s love for his wife, a mother’s love for her child, the love shared by siblings, the love of lifelong friendships — these are the ties that define us as human beings. Love gives us the courage to persevere in the face of life’s challenges. It gives us the resilience to bounce back from disappointments and comforts us in times of tragedy. Love adds sweetness to life’s successes and allows us to share its joys. What’s love got to do with life? Everything!

So, what happens when love ends? When a spouse or partner dies? Or love crashes on the jagged reef of divorce? The loss of love can have dangerous mental and physical repercussions that exact a toll beyond normal grief. A new study found that the lingering stress caused by the loss of a spouse or partner to death or divorce increased the risk of chronic illness. Men and women who were divorced or widowed were 20% more likely than married people to develop heart disease, diabetes or cancer, according to a recent survey of 8,600 adults from 51 to 61 years old by University of Chicago researchers.

The ending of a long-term relationship, whether from death or divorce, “really destroys financial assets, and it destroys health assets in the same way,” said University of Chicago sociologist Linda Waite, a co-author of the study. Financial strain, loneliness and uncertainty about the future create significant emotional stress. For some, the necessity of moving into more affordable housing or housing that is physically easier to maintain adds additional loss to their grief. Divorcing couples must cope with their children’s feelings of loss as well as their own. The duties once shared by two parents can feel overwhelming when only one parent is shouldering the burden. Combined, these things add to the burden of grief that follows the loss of a loved one, creating a persistent, overwhelming feeling of stress.

Over time, continuous stress erodes both our physical and mental health. Stress from grief or marital strife weakens the immune system, making us more susceptible to chronic disease, depression and anxiety. Strengthening existing relationships and building new relationships can help ease the strain, but some people will need professional psychiatric help to weather the storm and deal with their loss.

Preschoolers Can Suffer Depression

Children as young as 3 can suffer bouts of chronic clinical depression, a new study has found. It’s normal for preschoolers to have an occasional temper tantrum or moody day, but they usually bounce back, quickly returning to their normal, happy demeanor. When young children don’t resume normal play and activities or appear sad during play or incorporate themes of sadness or death in their play, they may be depressed.

“… people really haven’t paid much attention to depressive disorders in children under the age of 6,” study author, Dr. Joan Luby, a psychiatrist at Washington University in St. Louis, told the Associated Press. “They didn’t think it could happen … because children under 6 were too emotionally immature to experience it.”

The chemical imbalances in the brain associated with depression can occur at any age, but children are generally not brought to a psychiatrist for treatment until the turbulent teen years. Parents often report symptoms going back to early childhood that were not recognized as possible depression at the time. In addition to moodiness and sadness, symptoms of depression in preschoolers can include sleep problems, loss of appetite, frequent temper tantrums, hitting, biting and kicking.

Washington University researchers studied the mental health of 200 preschoolers aged 3 to 6 over a two-year period. Over the course of the study, 75 children were diagnosed with major depressive episodes. Previously conducted research indicates that about 2% of American preschoolers may suffer from depression at some point during their childhoods. Children who had experienced a traumatic event such as the death of a parent, physical or sexual abuse were more likely to become depressed. Children were also more likely to experience depression if their mothers were depressed or suffered from a mood disorder.

Published in the August issue of Archives of General Psychiatry, the study is the first significant research conducted on preschool depression. In previous studies it has been unclear whether preschoolers suffer the chronic depression common in older children and adults. However, in the Washington University study 64% of depressed preschoolers either remained depressed or suffered a recurrence after six months, and 40% still exhibited symptoms of depression at the end of the two-year study.

While the study did not address treatment protocols, cognitive-behavioral therapy is recommended as the first step in the treatment of depression in young children.

Sense of Fatalism Encourages Risky Behavior in Teens

A surprising number of teens expect to die young. In a seven-year study of 20,000 teens in grades 7 through 12, 15% felt it was highly likely that they would die before they reached their 35th birthday. Published in the July issue of Pediatrics, the unexpected results have caused researchers at the University of Minnesota to wonder if it is a feeling of hopeless fatalism rather than a sense of invulnerability that leads teens to engage in risky behavior.

The magnitude of teen-aged pessimism took researchers by surprise. University of Minnesota researcher Dr. Iris Borowsky told the Associated Press, Adolescence is “a time of great opportunity and for such a large minority of youth to feel like they don’t have a long life ahead of them was surprising.”

Males (15%) were slightly more likely than females (13%) to think they would die young. Living in a more stable family situation appeared to decrease the feeling of risk. Only 10% of teens who lived with both biological parents felt at risk, while 18% of those who lived with only one or neither of their biological parents felt they would die early. Lack of financial stability significantly increased the feeling of risk. Twenty-four percent of teens with a parent receiving public aid believed they would die at an early age. Racially and ethnically, the breakdown of perceived risk of early death was highest for groups exposed to the greatest deprivation and violence:

• 30% Native American
• 26% Black
• 21% Hispanic
• 15% Asian/Pacific Islander
• 10% White

While fatalistic teens did not die more often than their more optimistic peers (only 94 of the 20,000 teens participating died during the seven-year study), they were more likely to engage in unsafe behavior, including drug and alcohol abuse, unprotected sex, attempted suicide, and getting into fights that resulted in serious injury. Teens who believed they would die young were seven times more likely to contract AIDS than their positive-thinking peers. The perception that life was hopeless appears to have encouraged greater risk taking.

Psychiatrists are looking at the study in hopes of developing better methods for identifying at risk teens. It is hoped that the detection of fatalistic attitudes and thinking will help the medical community identify and treat at risk teens before they engage in dangerous behavior.

Brain Abnormality May Predict Depression

Structural differences in the brain appear to be linked to a greater risk of depression. In one of the largest, multi-generational brain imaging studies yet conducted, researchers at Columbia University Medical Center and the New York State Psychiatric Institute have discovered a correlation between thinning of the right hemisphere of the brain and the risk of depression. Study participants at high risk of developing depression exhibited a 28% thinning of the right cortex, the outermost surface of the brain, according an article published in the online edition of the Proceedings of the National Academy of Sciences.

The surprising loss of brain matter was similar to that experienced by people with Alzheimer’s disease and schizophrenia. “The difference was so great that at first we almost didn’t believe it,” admitted senior researcher Dr. Bradley Peterson, director of Child & Adolescent Psychiatry and director of MRI Research at the Department of Psychiatry at Columbia University Medical Center and the New York State Psychiatric Institute.

Researchers surmise that thinning of the cortex may disrupt the ability to process social and emotional cues from other people, potentially leading to depression. It’s important to note that researchers did not find a correlation between thinning on the right side of the brain and actual depression, but only to an increased risk of developing the illness. However, study participants who also exhibited thinning on the left side of the brain did develop depression or anxiety. Researchers also found that thinning of the cortex had a measurable negative impact on attention and memory. The thinner the cortex, the worse study participants did on attention and memory tests.

The biological children of depressed adults also exhibited thinner cortexes, giving credence to other studies indicating a potential genetic component to depression. Study co-leader Myrna Weissman, professor of epidemiology in psychiatry at Columbia University College of Physicians and Surgeons and director of the New York State Psychiatric Institute Division of Epidemiology, has tracked familial depression for 27 years. Now covering three generations, her study has found that depression is transmitted across generations in high risk families.

Researchers hope the study will open new avenues for diagnosing and treating depression. People with a family history of depression who exhibit thinning of the cortex may benefit from behavioral therapies that improve attention and memory and, possibly, from drugs used to treat ADHD.

Lack of Sleep Increases Risk of Dying

That sleepless night that makes you grouchy and tired the next day can be a killer — literally. New research shows that getting less than 5 hours of sleep a night increases your risk of death from cardiovascular disease. In a study of 4,600 men and women aged 35 to 55, researchers at University College London and the University of Warwick in the United Kingdom found that women who slept less than 8 hours per night had a higher risk of dying from cardiovascular disease than men. Differences in hormone levels may play a role.

According to data recently published in the journal Sleep, women who slept less than 5 hours per night had significantly higher levels of the inflammatory markers that are indicators for heart disease. Compared to women who were able to achieve a full 8 hours of sleep, risk levels increased dramatically with every hour of sleep lost. Even women who received 7 hours of sleep a night showed much higher levels of risk indicators than those who slept 8 hours.

A growing body of research indicates that sleep is a vital component to good physical and mental health. Chronic insomnia is also known to increase anxiety and contribute to depression, particularly in women. Another study reported in Sleep indicates a relationship between postpartum depression and the lack of sleep common to new mothers. In the Norwegian study, 60% of new mothers reported sleep problems with 16.5% showing symptoms of depression.

Researchers found that postpartum depression not only aggravated insomnia, but that complaints about sleep problems often interfered with the diagnosis of postpartum depression. Researchers found that many women who continued to report sleep problems two months after delivery were suffering from postpartum depression. However, because tiredness and lack of sleep are common complaints of new mothers, those suffering from postpartum depression often remained undiagnosed and untreated.

Researchers emphasized the importance of doctors discussing sleep problems with new mothers. Chronic lack of sleep that affects daytime functioning, results in a general lack of energy or that impacts other aspects of a new mother’s life could indicate postpartum depression. Depression screening is recommended to new mothers who continue to experience chronic insomnia. Treatment by a board certified psychiatrist can help women overcome postpartum depression, find solutions to chronic sleep problems, and enjoy their roles as new mothers.

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