I have recently finished watching a documentary on PBS titled ’Hiding in Plain Sight’ about mental health issues of young people in America. Some of the stories were truly harrowing and it really did make you wonder how their lives got to the point it did. It was a balanced documentary focussing on facts and not sensationalism and really did get to the heart of the issue. Below is the intro to the film;
Mental illness is a significant global health crisis—as pervasive as cancer, diabetes, and heart disease—but it often exists in secret and is endured in isolation. It’s the place where sadness leaves off and depression begins; where anticipation becomes anxiety, enthusiasm becomes mania, and habit becomes addiction; the place where simply living becomes painful. There are people struggling with mental illness all over the world: in remote rural communities, small towns, and major cities; in schools, the workplace, and in our homes. It is, in fact, a disease—a complicated one that has been a part of the human condition for thousands of years. Left undiagnosed, mental illness can last a lifetime. Left untreated, it can lead to addiction, homelessness, prison, or even death. The issues surrounding mental illness are extraordinarily complex; the risk factors are daunting, the economics bewildering, the politics contentious. Public policy, research, and education can help. But the most important step—and often the most difficult one—is to start talking about it.
As a therapist, I wholeheartedly agree with the concept of the film and indeed any film or organisation that promotes mental health. It is important that the stigma around particularly depression and anxiety is finally beaten and the more awareness that people have, the quicker this will happen.
Especially as on the same day that I saw this program, I read an article in the Times of London that stated that globally, there has been a massive increase in the use and prescription of anti-depressant medication. There was also evidence presented, of mental health professionals over-prescribing. While medication is essential for severe cases, I wonder what the long-term effects are of this for less serious cases. All of the participants in the program were on the full range of medication and had been caught up in the usual cycle of ’lets try this for a month and if it doesn’t work, lets try something else’.
One of the most interesting discussions on the program was the one concerning the so-called ‘nature versus nurture’ aspect of depression and anxiety, one that often divides opinion. The sensible outcome of this discussion with a child psychiatrist was that we might carry a ‘depression gene’ in a generational sense but it is the environment we grow up in that triggers it so both are important. However, for me, the environment plays a very important role.
Amongst the stories of young people suffering, there was for me, one “elephant in the room” that wasn’t covered. I don’t know whether this was intentional or not or whether the children’s stories were deemed more important but there was one thing that all the children had in common: bad or irrational parenting styles that they had been subjected to. This was despite the fact that the producers chose a broad cross section of children from different races and socio-economic levels. The children had seen domestic abuse, addiction, absent parents and had suffered abuse and neglect. This brings the question of just how important the environment that children grow up in is. I don’t think this was highlighted enough.
Particularly during the formative years of childhood, parents have a significant impact on the mental well-being of their offspring. Research has concentrated on three primary areas in order to better understand the impact of the parent-child interaction on the development of anxiety and depression in young children. These constructions are:
1. the extent to which a parent may be overprotective and/or critical
2. the degree to which parents model anxiety for their children.
3. the degree to which a youngster feels securely attached to his or her caretakers.
Every time a youngster is forced to contend with a challenging situation, whether it is emotional anguish or strife within the family, it has an impact on them in a number of different ways. There is even a specific phrase for these kinds of negative experiences during childhood, and it’s called adverse childhood experiences (ACEs). To put it more succinctly, these are potentially stressful situations that children are exposed to, such as domestic violence or divorce.
Situations that are typically considered ACEs include the following.
- Being a victim of violence, abuse or neglect at home
- Witnessing violent acts in your home or community
- A family member attempting or committing suicide
- Substance abuse
- Mental health problems
- Having parents who are separated/divorced
- A household member who is incarcerated
The extent to which a youngster avoids frightening circumstances is one of the most important variables in the maintenance of anxiety disorders. Parental behaviors, such as overprotection, that facilitate or promote avoidant techniques are likely to influence the maintenance and development of anxiety disorders. Overprotective and overinvolved parenting is likely to limit the child’s exposure to new and potentially frightening events. By eliminating these possibilities, it is hypothesized that the child will be less able to habituate to the perceived threat in these settings, less able to learn to reliably detect threat in new scenarios, and less likely to learn how to deal with challenging situations. Critical parenting is another parenting style that has attracted attention in relation to the development of emotional health disorders. Consistently, critical parenting has been linked to sadness and, to a lesser extent, anxiety. It is suggested that parents who criticize and minimize their children’s feelings damage their ability to regulate their emotions and increase their susceptibility to mental health issues such as anxiety and depression.
Underparenting and neglecting your children are the absolute worst things to do, but also too far in the opposite direction of overparenting is also likely to cause issues. Repeatedly shielding children from difficult, anxiety-inducing experiences can diminish their ability to cope. Anxiety disorders can be caused by a lack of self-control in the face of stressful conditions.
The inverse is possible in some circumstances. It’s possible that children are so accustomed to being shielded and numb to certain situations that they feel more empowered by doing the opposite of what their parents tell them to. It is possible for youngsters to become addicted to drugs and alcohol if their parents are overprotective of them. Children’s self-esteem might be lowered and even sadness or anxiety can result from parents who have a critical, dismissive tone of voice. The same can be said for judging your children’s self-worth or body image. Children are already dealing with a lot of emotions, and being too rigid might have a negative impact on their growth.
As we can see, parenting is crucial in a child’s development and while it is not the only factor in the acquisition of anxiety and depression, good parenting can make a big difference.