CHILD & ADOLESCENT PSYCHIATRY
Experiencing mental illness symptoms, like anxiety, sadness, or scattered thinking is bewildering. When it’s your child who’s experiencing these symptoms, it’s all the more confusing and unsettling. For both parents and children facing mental illness symptoms, some common questions include: “Why am I feeling this way?”, “Where is this coming from?”, “How can I help?”
For the family and the provider, these are great questions to start asking. The the “why”, “how”, and “what can be done” questions are the foundation of my integrative approach to assessment and treatment. In taking a whole-person approach to caring for children and adolescents experiencing mental illness, my process is guided by three principles: education, options, and empowerment.
Connecting The Dots
Education is about helping children and adolescents (as well as their parents) to understand the “why”. For any individual experiencing mental illness, the cause may never be fully known. But asking questions can help identify some important contributing factors. In many cases, life stress or past traumatic experiences are the primary drivers of symptoms. For others, genetics play a big role. And, often overlooked, physical imbalances can alter our brain chemistry and contribute to the onset of mental illness symptoms. Typically, it’s not just one singular cause either. There’s a list of usual suspects, but figuring out which ones conspired to produce the symptoms is the first and most important task. For that, education is critical. It’s important to connect the dots between environmental stressors and mental illness symptoms. Doing so means that you likely have a better chance of making improvements.
Putting in the time and effort to educate patients and parents, and to help them to understand the “why”, offers a few advantages. First, it leads family/provider team to a treatment plan that best targets the symptoms and addresses the underlying contributing factors. Second, it improves the confidence of both the child/adolescent and their parents. When parents feel more confident in their ability to help their children, then children undoubtedly do much better.
Leave No Stone Unturned
Options is about creating a menu of treatment interventions that can attack the problem from all sides. For a long time, psychiatry has operated with a mindset borrowed from the practice of medicine at large. That is the one disease-one treatment approach to care. For broken bones or heart attacks, this is the best way to go. When it comes to mental illness, however, problems are not so simple, and not so easily solved. Multiple strategies working together at once tends to produce better results for those experiencing mental illness. But, which things should you try? For each individual patient, this will depend on their unique story, the various environmental stressors they have faced, and their distinct collection of symptoms.
Psychiatric medications fit neatly into the one disease-one treatment model. To be clear, psychiatric medication have their place in the treatment of mental illness, especially in cases where symptoms are severe or overwhelming in the immediate term. Yet, just using medications tends not to produce the best outcomes. The integrative approach is just that, integrative. In addition to medications, the integrative approach considers what kind of psychotherapy would be a good fit for the problem, what imbalances in the body could be corrected, and what lifestyle habits need to change for the better. Thinking about what else can be done is important, not only because increases the chances of recovery, but also because it offers parents the comfort and confidence of knowing that no stone was left unturned in their child’s care.
Passing The Baton
Empowerment is about helping patients put their finger on the problem. With an awareness of how it all came to be, patients’ recovery can be sustained. In recovering from mental illness, focusing on what not to do is equally as important as what to do. Treatment can easily fast forward to the stage of asking “Which medication should we start with?”, “What supplement protocol should I be taking?”, or “How much cardio should I be doing?” Asking questions about what to do is less important than asking questions about what contributed to the onset of mental illness in the first place. In asking these questions, we can discover more about our patterns of responding that may have added to the current day stress and suffering. It’s about figuring out which ways of coping were helpful, and which ways of coping were not so helpful.
As with adults, in treating children and adolescents with mental illness symptoms, we must ask, “how was I coping before?” The answer to that question will vary from person to person, but it will also depend on a person’s age. For kids, it’s vitally important to consider the developmental stage when creating a treatment plan. As an example, and elementary school child will cope with life stress in very different ways than an adolescent would. That’s a good thing. In child psychiatry, letting the developmental stage guide the approach to assessment and treatment is key. At every developmental stage there is a challenge that children need to face and overcome. Connecting the treatment plan to the developmental challenge currently in front of a child or adolescent can make a world of difference. It’s a lot to ask of a kid to start taking medications, quit junk food, put their phone down, go to sleep earlier, start exercising more, and go to therapy once a week. Aligning the goals of treatment with the developmental challenge improves both children and adolescent’s motivation to do the work as well as their acceptance of the diagnosis and treatment plan.
Treating The Whole Person
Beyond therapy and medication, an integrative approach can help to educate and empower both children/adolescents and their parents. It’s a whole-person approach that helps parents feel more confident, and at the same time offers more autonomy and independence for the child/adolescent in need. The integrative approach seeks to build knowledge and strength in the child/adolescent as well as within the family.