Ways To Help A Loved On Who’s Coping With Depression

depressionfamMore likely than not, someone you love—your significant other, BFF, or family member—is dealing with depression or anxiety. Nearly 50 percent of American adults will develop at least one mental illness during their lifetime, according to the Centers for Disease Control and Prevention (CDC). And because of the widespread stigma surrounding mental illness, many people hesitate to ask for help. So if a loved one reveals that they are suffering—or if you think they are—your compassion can help them through the recovery process.

 

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When depressed gay men turn to each other for help

When depressed or suicidal

be a good wingman:

Having a friend ask if you’re OK can make the world of difference

When depressed, gay men turn to each other for help

Gay men are most likely to reach out to other gay men when they’re depressed or anxious and new resource will make it easier for men to support their friends.

LGBTI are more likely to experience depression and anxiety than the broader population. They are also at a greater risk of suicide and self-harm.

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Hurting at the Holidays? 7 Common-sense Strategies

Coping with your less-than-ideal family during the season of thanks and joy
 
 
 
 

 

It’s not even Thanksgiving, but Christmas is everywhere in New York City, as it has been since the day after Halloween.  I no longer dread the holidays the way I once did but the idealized image —of that big, happy, smiling family—still eludes me, as it did during my childhood and later.  For unloved daughters and sons, the stress of the holidays sweeps in much more than the nuisance of crowded stores, piped-in joys, worries about money or pleasing everyone with the right gift.

For many, it will conjure up—almost as if fresh and new—the pain, exclusion, and loss they felt in their families of origin. For women who continue to interact with their unloving mothers—for whatever reason—the holidays can throw all the stresses and pains of past and present into high relief. For those who have made the difficult and painful decision of going “no contact,” the holidays sometimes evoke a renewed sense of self-doubt about the decision made, along with a feeling of isolation.  The weight of cultural disapproval may feel heavier at this time of year.

 

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Offspring of Parents With Bipolar Disorder

CHILD AND ADOLESCENT PSYCHIATRY 
 
 

 

 
 
 
 

 

It is generally held that the offspring of parents with bipolar disorder (BD) are at risk for BD. The degree of risk is an important question for both clinicians and parents. A recent study of bipolar offspring by Birmaher and colleagues1 sheds light on this issue.

These authors compared the lifetime prevalence of bipolar and other psychiatric disorders in children whose parents had–or did not have–BD. The study involved 233 parents with BD and their 388 offspring and a control group of 143 parents without BD and their 251 offspring.

Parents with BD were recruited from outpatient clinics and advertisements for participation in the study. On the basis of diagnostic interviews, 158 parents had bipolar I disorder and 75 had bipolar II disorder. The majority (80%) of the parents interviewed were female. The mean age of parents with BD was 40 years. Sixty-four percent of parents reported that the onset of their mood disorder occurred before they were 20 years old. Parents with BD were less likely to be married at the time of intake and had a slightly lower socioeconomic status than parents without BD.

The offspring of parents with BD did not have to be symptomatic to participate in the study. The mean age of these children was 12 years; 49% were female; and 88% were white. Fewer than half (42%) were living with both biological parents.

The rate of bipolar spectrum disorder in the offspring of parents with BD was 10.6% versus 0.8% in the offspring of control parents. The rate of bipolar I disorder was 2.1%; bipolar II disorder, 1.3%; and bipolar not otherwise specified (NOS), 7.2%. The rate of BD increased substantially–to 29%–when both parents had BD.

Overall, the offspring of parents with BD were at significantly greater risk (52%) for any Axis I disorder than those in the control group (29%).

The majority (76%) of these offspring experienced childhood-onset bipolar disorder before age 12 years. Bipolar NOS was the most common first episode of illness. Rates of comorbidity in these youths were high: 51% had anxiety disorder, 53% had disruptive behavior disorder, and 39% had attention-deficit/hyperactivity disorder (ADHD).

The authors concluded that there is a 14-fold increase in the rate of bipolar spectrum disorder in youths who have a biological parent with BD. If both parents have BD, then the offspring are 3 times more likely to have BD.

The mean age of youths in this study was 12 years. Prevalence rates may therefore be an underestimate because some children with depression may become bipolar in adolescence. It is recommended that clinicians who treat adults with BD inquire about the functioning of their children to provide appropriate early intervention.

Posttraumatic stress disorder and substance abuse

In a family study of BD in youths, Steinbuchel and colleagues2 investigated the relationships among adolescent BD, posttraumatic stress disorder (PTSD), and substance use disorder (SUD). Because adults with BD who were severely abused as children are at high risk for SUD, these investigators sought to determine whether there is a similar association in adolescents.

A total of 105 adolescent offspring of parents with BD and a control group of 98 youths without mood disorders participated in this study. The diagnosis of BD was based on structured psychiatric interviews. SUDs included any alcohol(Drug information on alcohol) or drug abuse or dependence.

Rates of PTSD were significantly higher in adolescents with BD than in the control group. Sixteen percent of youths with BD had full or subthreshold PTSD compared with 3% in the control group. These youths had experienced trauma in the form of physical abuse, sexual abuse, witnessing of death, or family violence. Rates of SUDs were higher among youths with BD than in those in the control group (32% vs 4%, respectively). Alcohol was the most frequently used substance (86%) followed by marijuana (71%) and tobacco (29%).

What was the temporal order of these disorders? In half of the cases, BD preceded PTSD. In the other half of cases, PTSD was diagnosed before BD. For those youths in whom SUD developed, the majority had BD followed by PTSD and then SUD.

This study confirms an association between PTSD in adolescents with BD and subsequent development of SUD. Rates of SUD were higher in those youths who met full criteria for PTSD than for those with subthreshold symptoms. The findings reveal that BD increases the risk for PTSD, which in turn increases the risk for SUDs. The investigators suggest that treatment of adolescents with BD may prevent trauma related to the development of PTSD and subsequent SUD. It is recommended that clinicians who treat adolescents with BD evaluate for the presence of PTSD and SUD.

 
By Karen Dineen Wagner, MD, PhD  
 
Dr Wagner is the Marie B. Gale Centennial Professor and vice chair of the department of psychiatry and behavioral sciences and director of child and adolescent psychiatry at the University of Texas Medical Branch at Galveston.
 
http://www.psychiatrictimes.com
 
 
 
 

References

1. Birmaher B, Axelson D, Monk K, et al. Lifetime psychiatric disorders in school-aged offspring of parents with bipolar disorder: the Pittsburgh Bipolar Offspring study. Arch Gen Psychiatry. 2009;66:287-296.

2. Steinbuchel PH, Wilens TE, Adamson JJ, Sgambati S. Posttraumatic stress disorder and substance use disorder in adolescent bipolar disorder. Bipolar Disord. 2009;11:198-204.

Healing the Cycles that Tear Couples Apart