Now that the holidays are behind us, it is time to think of New Year’s resolutions. In January, people contemplate their physical health, making goals to exercise regularly, eat healthier, sleep more, get physicals and take better care of themselves. But how often do families consider the state of their mental health? The truism, “Prevention is better than cure,” applies to mental well-being as well as physical.
Here’s some wisdom from Mental Health America, a national nonprofit founded in 1909 to address the needs of those living with mental illness:
When we think about cancer, heart disease or diabetes, we don’t wait years to treat them. We start way before Stage 4. We begin with prevention. And when people are in the first stage of those diseases and have a persistent cough, high blood pressure or high blood sugar, we try immediately to reverse these symptoms. This is what we should be doing when people have serious mental illnesses.
This applies to children as well as adults. “What we know is that the onset of more than 50 percent of all mental illness occurs before the age of 14, and 75 percent of mental illness manifests before the age of 24,” says William Arroyo, M.D., associate medical director of the Los Angeles County Department of Mental Health.
SoCal dad Donald Morrow raised his children while also caring for his wife, who suffered abuse as a teen and was diagnosed with bipolar disorder. “Ultimately, all mental illness starts in the formative years,” says Morrow. “It stems from loneliness, acute or chronic abuse or trauma, and stress can exacerbate it. By dealing with the issue in time, you can help nip it in the bud.”
The Impact on Children
Key research in this area comes from the Adverse Childhood Experiences (ACEs) study conducted in the 1990s by Kaiser Permanente and the Centers for Disease Control and Prevention. The study correlates traumatic experiences during childhood with a host of issues later in life. These include depression, substance abuse and major mental illness such as schizophrenia, as well as heart, lung and liver disease, obesity, suicide and early death.
“Even homelessness has been highly correlated with childhood trauma,” says Anna Henderson, executive director of the Westside Infant-Family Network (WIN), which provides mental-health services to underserved families with young children.
Kylie Foster, LCSW, a therapist who works with WIN, says children’s mental health can even be impacted in utero. “Typically, the placenta gates for spikes in stress hormones like cortisol, protecting the unborn child from these helpful but neurotoxic hormones. However, for a mother under extreme, prolonged stress, like a war zone, an intimate partner/domestic violence situation or other extreme adversity, the placenta allows cortisol through ungated,” she says. “It directly affects the developing brain, priming that child for a lifetime of adversity. Studies have shown that a child’s cortisol reactivity may remain atypical throughout life.”
The CDC estimates that only about 17 percent of U.S. adults are considered to be in a state of optimal mental health. It reports depression as the most common mental illness, impacting more than 26 percent of the U.S. adult population and on track to become the second leading cause of disability worldwide by 2020.
Breaking the Cycle
In a family where violence, regular conflict or mental illness is prevalent, parents should work to break the cycle for the sake of themselves, their children and future generations of their family. “Trauma is happening in families’ homes from kids’ youngest ages, and it tends to pass from generation to generation, from traumatized parent to then-traumatized child, and so on,” says Henderson. “It’s a whole-family issue that crosses economic, cultural and racial bounds.
“It is not about blaming parents for children’s mental health issues,” she says. “It’s about recognizing that our family secrets are affecting us – and then working with whole families to heal past trauma, repair and support healthy relationships, and prevent transmission of trauma to the next generation.”
Arroyo says mental health checkups for families with a history of mental illness, a predisposition to substance abuse or prolonged stressors such as financial difficulties are essential. Awareness and self-monitoring among at-risk individuals is the first stage of care. If the person undergoing symptoms is unable to seek help, Arroyo stresses the importance of a loved one stepping in.
Parents can face a broad spectrum of issues including anxiety, depression or substance abuse – all of which could be related to trauma during their own childhoods. And Henderson says these can be exacerbated by “the pressures, stresses and expectations of parenting itself.”
Protecting the welfare of their children can often motivate parents who would otherwise shy away from seeking help. “As a parent, just knowing that my depression or alcohol dependence or family conflict has a good chance of affecting my child right now and into the future arms me with the knowledge that if I get help, I can make my child’s future better as well,” says Henderson. “I can use this opportunity to improve [our] relationship and end a cycle of issues that may have even dated back before my grandparents.”
Cameron Gearen, a writer, college counselor and mother of two, understands this well. “The best gift I have given my kids in terms of helping with their mental health has been to stay religiously on top of any of my own issues so that I can be as healthy as possible,” she says. That has meant working with her own therapist, paying attention to self-care and resisting unhealthy tendencies such as impulsivity.
Mental Health at Home
Arroyo says parents should learn about their extended family’s history, patterns and the predispositions that can impact their children. Knowing and understanding family history of trauma, substance abuse or depression helps parents understand what to look out for in themselves – and their kids.
Parents can take steps to create a home environment that promotes good mental health. Experts from WIN and others suggest the following:
Communication: Build open, honest relationships with your kids through conversation during car rides, at the dinner table or during a specially arranged weekly coffee or movie date between parent and child.
Consistency: Structure – including regular mealtimes, bedtimes, and reasonable consequences for unwanted behavior – helps children feel safe and confident.
Observation: Actively observe your children’s behavior and watch for any abnormalities or discrepancies that could be a sign of trauma, stress or abuse. Also, be familiar with your children’s social circles.
Modeling: Avoid using derogatory language to describe mental illness and people experiencing mental illness. Discuss prevention and treatment of mental illness just as you would physical ailments such as heart disease or diabetes. This makes it easier for everyone in the family to open up about stressors or concerns and feel free to ask for professional help.
Asking for Help
When parents notice changes in their child’s behavior and suspect an issue, they should be able to lean on their village for help. In fact, Arroyo says, schools and counselors have an important role to play in children’s mental health. Some schools even provide wellness centers and family counseling.
Mental health issues in children are often mistaken for developmental delays or behavior issues including chronic aggression, obsessive or compulsive behavior or separation anxiety, according to Foster. “We’ve worked with kids expelled from preschool multiple times for violent behavior, who have witnessed domestic violence from birth, and children who were banging their heads or rocking repeatedly — who were not on the spectrum, but had been raised by parents with serious depression or mental health issues,” she says.
The L.A. County Department of Mental Health also offers a 24-hour helpline (800-854-7771) to connect families with mental-health services. And the department’s website, dmh.lacounty.gov, features links to mental-health resources, community clinics, a glossary of mental-health terms and stories of people who have found help.
So as you make your resolutions this new year – to start an exercise program, eat more fruits and vegetables or spend more family time – consider making one more. Take a brave look at the history of your family, the state of your own mental health and the outlook for your children. It could make all the difference in your family’s future.
Kaumudi Marathé is a journalist, chef and mom of a teen daughter. Kaumudi teaches cooking, writes freelance and runs long distances in Glendale.